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JENNER AND VACCINATION: 

J SttMgt dfeafltr of Ptbital gistors- 

BY 

CHARLES CREIGHTON, M.D. 

Prisca fides ficto, aed fama perennis. — Vmnii. ; Aiiieid, ix. 



SWAN SONNENSCHEIN & CO., 
PATERNOSTER SQUARE. 



Butler & Tanner, 

The Selwood printing works, 

Fromb, and London. 



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PRE FACE. 



THE object of this book is to make clear to general 
readers the steps in the rise and acceptance of 
Jenner's doctrine and practice of vaccine inoculation. 
The assent of the profession both at home and abroad 
having been given within the first two or three years, 
the history has been followed most closely for those 
years. The subsequent establishment, endowment, and 
enforcement of the doctrine and practice are narrated 
with less minuteness in the concluding chapters. The 
history being a somewhat strange one, it has been 
thought desirable to authenticate the facts by full refer- 
ences. The events herein narrated and criticised are 
remote enough from our own day to have become fitting 
matter for historical treatment. In medicine new de- 
velopments of theory and practice are so closely bound 
up with the legitinJate^'prftf^spionaJ standing and -Repute 
of their authors that-'ft^ Js'!:£iwayi.airaatiei:,6f',<Jeliq?icy 
to subject them to contemporary criticism of the more 
rigorous kind. But there need be no such reserve in 
dealing with medical affairs that lie well within the 
limits of history. The medical profession of this 



lU 



IV PREFACE. 

country, it is true, has offered no great encouragement 
to those who would touch even the history with a 
hand of criticism. But the public can hardly be ex- 
pected to share that pious feeling so far as concerns 
a practice that is brought home to every one by the 
law ; the historical origins, or the roots of authority, 
may here be laid bare without compunction. In most 
other affairs of the past it is not only permitted to 
historians, but even expected of them, that they leave 
no stone unturned. 

Technical language has been avoided as far as pos- 
sible, and has, indeed, been little needed in dealing 
with a subject which is a commonplace of every house- 
hold. Some of the points the author has been enabled 
to pass over briefly with a reference to a former book 
written for his own profession. He has been enabled 
also to curtail where his immediate precursor in the 
history of vaccination, Mr. William White, has been 
most copious. Those who are acquainted with Mr. 
White's able and accurate historical inquiries will find 
that the present work for the most part covers new 
ground. 

London, 

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CONTENTS. 



CHAPTER I. . 
jenner's scientific credit before vaccination. 

Jenner and John Hunter. — Banks' and Cook's Expeditions. — Hunter's 
Letters. — Hibernation. — ^The Cuckoo. — Paper for the Royal Society. 
— Elected Fellow. — Theory of Cuckoo's Instinct. — ^Jenner's Origin- 
ality. — A Wondrous Tale. — Imaginative Anatomy of Cuckoo's Back. 
— Accepted by Ornithologists //. 1-18. 

CHAPTER II. 

THE POX, THE SMALLPOX, AND THE COWPOX. 

The Folklore of Cowpox. — The Legend a Localized One. — Origin of the 
Legend. — Benjamin Jesty. — A Second Theme for the Royal Society. 
— Origin of the Name "Smallpox."— Origin of the Name **Pox." — 
Why the Pox so Called. — Why Cowpox so Called. — The Legend to 
be made Scientific. — Jenner's Notions get Wind. — His Paper Returned 
by the Royal Society. — His Original Theory. — The Evidence. — A 
Sham Test. — Cowpox not Fully Described. — Implied Likeness to 
Smallpox. — Called " Smallpox of the Cow." — No Reasons Given. — 
Facts Suppressed. — James Phipps Tested. — Significance of Royal 
Society's Action pp. 19-48. 

CHAPTER III. 
JENNER'S "inquiry." 

The Horse-Grease Doctrine Appears. — The Paper Re-Written. — The 
Preface or Programme. — "Vague and Indeterminate Notions." — 
Cowpox as known to Fewster and others. — As known to Clayton the 
Veterinarian. — Evidence of Farmers. — '*A few Solitary Instances." 
— Experiment is Better. — Cowpox due to Common Causes. — Jenner 
Denies Spontaneous Cowpox. — Invents "Spurious." — Misleading 
Likeness to Horse-Grease Sores. — Horse-Grease the Origin of Cow- 
pox and Smallpojc. — ^John Baker Inoculated with the Grease. — 
Circumstances of liis L)^at?)j-^5noculation8 wiih'Cjowpox .iJsdf.-r-To 
the Fourth Removfe. — J(5i\ni^f,gc«s to I^ondpn.^j^MM^PuMis'hid. — 
Cline. — Jenner OmitS the Test.^^-^mmary'o^^he /n^try^ '^ ^ 

/A 49-77- 
CHAPTER IV. 

THE RECEPTION OF THE "INQUIRY." 

** Smallpox of the Cow" Accepted. — The New Name Defended. — Pear- 
son's Objection. — Dr. John Sims and the Jacobs Case. — John 
Lawrence on **The Filth and Nastiness of Cowpox." — A Conscious 



CONTENTS. 



17™.— Dr. Ingen-housz.— Priva 
Offers to begin Vaccinating.— Je 
Staoehouse. — Jenner's Expeiienci 
with it.— Drake's Experience at 
Woodville to the Rescue . 



e Opinion of Beddoes.— Knight 
iner without Lymph. — Cowpos at 
with it. — Thornton's Experience 
Stroud. — Threatened Collapse. — 
. . . . pp. 7S-100. 



CHAPTER V. 
COWPOX MADE MILD AND I 
Woodville's Antecedents. — Pearson and Woodville.— Co wpox in Gray's 
Inn Lane.— A Mild Type.— Source of the Worid's Vaccine— Causes 
of Woodville's Success.- — Pedigree of his Stock. — Lymph from a 
Dairymaid's Hand, — Jenner Supplied by Woodville, but Seeks to 
Raise a Stock of his own.— The Public Mystified.- Misleading Effect 
of Woodville's Mild Type. — The Real Affioities of Cowpox. — Hicord's 
Experiments lo Inoculate Syphilis. — Henry Lee's Experiments and 
Plales.— The Vaccine Vesicle in Ordinary.— The Vesicle of Horse- 
Grease. — Want of Dialectical Sciutiny . . • //. 101-124. 

CHAPTER VI. 
THE VARIOLOUS TEST. 
Experiment and Experience.- James Phipps Tested.— The Test Faib at 
Stroud.- Woodville's Cases Tested.- Pearson's Tests.— Manchester 
Tests and their Result. — Failures Reported to Jenner. — The Average 
Experience.— Variolation as a Test and as an End in itself. — Old- 
fashioned Variolation.. — The New Method of Gatti. — Found out to be 
a Sham. — Daniel Sutton and Dimsdale.^ — Bromfeild and Langton 
Protest against Sham Inoculation— What Woodville Desired.- The 
Sham Melhod General.— Jenner Recommends Ihe Test in its most 
Illusory Form. — An Asloundirig Foi^etfulness in the Profession at 
Large. — Other Fallacies of the Test. — Obstructed Lymphatic Glands. 
— Sores on the Arm. — Interference of Emplions, etc. //. 125-154. 

CHAPTER VII. 
THE FIRST APOLOGIES FOR FAILURE. 
Jennet's Foresight.- Horse-Grease the only Genuine Source.— Discredited 
by Events. — New Definitions of "Spurious." — Horse-Grease Dropped 
by Jenner.— Taken up by Others.— J enner's Origin of the Vaccine 
Inoculalinn a Retrospective Fable.— His Early DifKcuIlies. — An 
JiJUton's Shoij^Meoioi}'.— --Audaaiijuj- ^tfindaclty. — Argument of the 
^Hitiilr Vtiervaittni AnteSatedi-^.^i ^We Beld of Experiment."- 
WoiJdiifll's- ■R.AiCeSce.'—^ngen-iiousl'OQ" '"Spurious Smallpox." — 
Henry Jenner on Spurious Cowpox. — Rev. T. D. Fosbroke Explains 
Spurious Cowpox.— Rev. G. C. Jenner on Spurious Vaccine. —The 
Profession Demands Definition of " Spurious. — Dr. John Stevenson. 
— Dcnman and Lord Derby. — Dunning States the Issue. — Double 
Use of the " Spurious " Ciy.^Ulceralion of the Vesicle. — The Clap- 
ham Cases. — Smallpox after Vaccination is called Chicken-pox. — A 
Mystical Eicuse. — Long Career of Apologetics Begun //, 155-182. 



CONTENTS. Vll 

CHAPTER VIII. 

GENERAL ASSENT IN ENGLAND. 

Quality of the First Vaccinists. — Criticism Silenced by Abuse. — The 
Leaders of Opinion. — Scientific Assent. — The London Testimonial of 
July, 1800. — ^Jenner Confirmed on Every Point. — Completely Estab- 
lished before Two Years. — Approval by the Public — Jenner Petitions 
Parliament for a Reward. — Admiral Berkeley's Committee. — Mono- 
tonous Evidence of the Medical Leaders. — Jenner gives his ** Concise 
History."— The Opposition Confined to Variolators. — The Variolous 
Test not Exposed.— Decision of Parliament. — The Committee Com- 
posed of ** Friends of the Petitioner "... pp, 183-203. 

CHAPTER IX. 

THE GERMAN ENDORSEMENT. 

Securus judicat orbis terrarum. — The Gottingen Academy of Sciences. — 
Osiander's Book. — The Variolous Test at Hanover. — The Epidemic 
Test. — The Fiasco at Oebisfelde. — Wardenburg*s Doctrine of Spurious- 
ness. — Bremen Experiences. —The Danish Commission. — Berlin. — 
Hufeland's Enthusiasm. — Official Prussian Inquiry. — The King Im- 
partial. — Results of the Inquiry. — The Movement in Breslau. — Struve's 
Tests at Gorlitz. — Sommerring's Tests at Frankfurt. — Satires upon 
Vaccinators. — The New Mode Demanded by the Public — Hessian 
Experience. — A Failure at Meissen. — Bavaria. — The Innovation in 
Vienna. — Criticisms by the Salzburg Journal. — Formal Tests at 
Vienna. — Vaccination Useful against Plague, Scarlet Fever, Dog- 
distemper, and Sheep-pox pp. 204-238. 

CHAPTER X. 

RECEPTION OF COWPOX IN FRANCE. 

Petite virole des vaches, — Jenner too Deep for Verdier. — The Field Open 
in France. — Comit^ Central de Vaccine. — Opposition by Vaume. — 
Analysis of Verdier's Objections. — A Reply from Montpellier. — 
Validity of the Variolous Test not Criticised. — Salmade's Mode of 
Inoculating Smallpox. — Eruption not Essential to Success. — Heber- 
den*s Law of Interference Disregarded. — Voisin's Tests at Versailles. 
— Colon's Tests in Paris. — Grand Decisive Test by the Comit^ 
Central. — Notorious Failure at Toux. — Excused by the Lyons Com- 
mission. — The Test at Lyons. — The Amiens "Jury of Health" and 
Lord Cornwallis pp, 239-266. 

CHAPTER XL 

THE JENNER OF ITALY. 

Sacco's Antecedents. — Discovery of Cowpox at Varese. — Sacco*s Ideal 
Plate of Cowpox on the Teats. — The Varese Cowpox Spontaneous. — 
Sacco's Pathology. — Experiments with Cowpox on many Species of 
Animals. — Cowpox against Sheep-pox. — Dr. William Budd's Coht 



VIU CONTENTS. 

elusion. — Men not like Sheep. — Dr. Legni Uses Sheep-pox as Vaccifte.' 
— Sacco Adopts the Horse-Grease Doctrine and Practice. — "Equine" 
in Vienna. — Sacco Hailed as the Jenner of Lombardy. — Epidemics 
Stamped Out. — Formal Variolous Test at the Milan Orphanage. — 
The Test at Florence. — Sacco's Oration in 1832. — Vaccinal Syphilis 
in Italy. — Marshall in Palermo. — Monteverde's Statue of ** Jenner 
Vaccinating his Child "... . . , . pp. 267-290. 

CHAPTER XII. 

ASSENT TO A MYSTERY. 

Dignified Associations of Vaccination. — Protection by Cowpox an Ac- 
knowledged Mystery. — The Intellectual Difficulty soon Forgotten. — 
Newman on Assenting to a Mystery. — Real and Notional Assent. — 
Scientific Ramifications Pursued with Exact Diligence. — Popular 
Assent not to the Mystery, but to each of its Component Propositions. 
— The Rude Intellect of the World at Large. — Popular Assent to the 
Several Parts of Vaccine Doctrine. — ^The Doctrine as a Whole a 
Subject for Pathology. — Has Pathology done its Duty ?— The Doctrine 
in Parliament, 1840. — Again in 1853 : Lord Lyttelton. — The Blue- 
Book of 1857. — A Smallpox which is not Smallpox, but Prevents 
Smallpox. — '*A Scientific Principle" Foreshadowed. — Enunciated by 
M. Pasteur as the Methodical Attenuation of Virus. — Historical 
Origins of Cowpox Forgotten. — " Vaccin" has become a Figure of 
Speech ......... pp. 291-309. 

CHAPTER XIII. 

ESTABLISHMENT AMIDST DISSENT. 

Dr. Moseley, the First Anti-Vaccinist. — His Influence in London Society. 
— Other Opponents. — Disillusion in 1804. — Goldson's Book. — Ring's 
Reply. — Credit Shaken. — Jenner's Appeal to the Aristocracy. — The 
College of Physicians called on to Judge. — Sir Lucas Pepys. — Second 
Grant to Jenner. — Radical Malcontents. — The Vaccine Board. — The 
Grosvenor Case. — S. T. Coleridge. — Belief Mainly Official. — ^Lord 
Boringdon's First Bill. — Second Bill also Defeated : Speeches in the 
House of Lords. — The Epidemic of 1817-18. — " Modified '* Small- 
pox //. 310-335. 

CHAPTER XIV. 
COMPULSION. 

A Moment of Hesitation. — Corporation Interests in the Way. — The Pro- 
fession Tired of Jenner. — Return to the Old Inoculation. — Epidemic 
of 1824-25. — Last Protests in the Medical Press. — Legislation of 
1840. — Lord Lyttelton*s Act.— The Epidemiological Society. — Doc- 
trine of Nuisance to One's Neighbour. — Doctrine of Omissional 
Infanticide. — The Principles of Sangrado. — Anti-Vaccinist Scrutiny. 
— Evidence of Facts in the Epidemic of 1871-72. — No Surrender. — 
A Question for the Public. ..... //. 336-354. 



JENNERIAN DOCTRINE OF VACCINE. 



-•<« 



CHAPTER I. 
jenner's scientific credit before vaccination, 

WHEN Dr. Edward Jenner came before the world 
to recommend cowpox as an effective substitute 
for smallpox in the way of inoculation, he had been for 
nine years a Fellow of the Royal Society, with a consider- 
able intimacy among leading men in London. When 
the evidence for his alleged discovery was challenged 
by Dr. Ingen-hdusz, a foreign physician and scientific 
writer of great repute, who happened just then to be on 
a visit to Lord Lansdowne, at Bowood, Jenner promptly 
stood upon his dignity as being himself a scientific 
personage not unknown, and thus wrote to his foreign 
critic : " Truth, believe me, sir, in this and every other 
physiological investigation which has occupied my 
attention, has ever been the object which I have 
endeavoured to hold in view." ^ 

What, then, were these earlier physiological inquiries 

^ Baron's Life of Edward Jenner^ M,D^ 2 vols. London, 
1 827-1 838, i. 294. , 



2 SCIENTIFIC CREDIT BEFORE VACCINATION. 

to which Jenner appealed ? and what were the grounds 
of his being taken seriously, as unquestionably he was 
taken seriously, by leading men in medicine and science 
whenever his first essay on cowpox issued from the 
press ? 

Jenner came of a prosperous family in the Church, 
who held benefices in succession, as well as a small 
landed estate in the Berkeley country of Gloucester- 
shire. When he had finished his apprenticeship with an 
able country surgeon, Mr. Ludlow, of Sodbury, whose 
son and partner had been a pupil of John Hunter's, in 
London, Jenner was sent, at the cost of his elder brother, 
to become in like manner a boarder and pupil in John 
Hunter's house. Hunter's fee for each pupil was five 
hundred guineas, the pupil being bound for five years ; ^ 
but as Jenner had already completed his indentures 
with Ludlow, he remained only two years with Hunter, 
and was probably received at an annual rate for so long 
as he cared to stay. In Hunter's house and workrooms, 
he was in a centre of great influence and of many op- 
portunities. Among his youthful contemporaries were 
Everard Home, Cline, and others, who had become men 
of influence by the time that Jenner came forward as 
the advocate of cowpox six-and-twenty years after. 
Shortly after he went to board with Hunter, Banks came 
home in 177 1 with a large collection of objects which 
he had made, with the help of Solander, as naturalist on 
Captain Cook's first -expedition to observe the transit 
of Venus in the South Seas, and Jenner was set to work 
upon the specimens. There is nothing in his own 

* Ottley's Ufe of J, Hunter^ p. 34. 



JENNER AND BANKS. 3 

writings, or in any of his observations that Hunter made 
use of, to show that he ever acquired any technical skill in 
dissecting and preparing. The set of injected specimens, 
showing the stages in the development of the hen's egg, 
which he bequeathed to his executor, Dr. Baron, was 
probably one of the purchases which Hunter made for 
him at the sale of Hewson's fine preparations,^ although 
Baron assumes without evidence that they were Jenner's 
own handiwork, and praises him, accordingly, for his 
anatomical skill. But there were other humble ways in 
which an apprentice of Hunter's could be useful to 
Banks ; and, at all events, Jenner made the acquaintance 
of the man who was destined to occupy the chair of the 
Royal Society for many years, and to be the Maecenas 
of science. It is at this point that the Jennerian mythus 
begins in the pages of the biographer. Baron. Jenner, 
we are told, was offered the post of naturalist with 
Cook's second, or 1772, expedition to the Pacific. The 
facts are as follows : Banks failed to induce the Govern- 
ment to allow himself, and the assistants whom he had 
selected, to accompany the second expedition in 1772, 
although he had been so far led to expect their consent 
as to have his appliances all ready and a scientific staff 
chosen. In order that his preparations should not be 
altogether in vain, and his assistants unemployed, he 
himself fitted out a naturalists' expedition to Iceland ; 
but Jenner was not one of those who sailed with it. 
Jenner remained a few months longer with Hunter, and 
returned in the end of 1772 to Berkeley, where he com- 



* Hunter to Jenner, 30th Aug., 25th Sept., and 9th Nov., 1778, 
in Ottley's Life of J, Hunter^ pp. 7o> 7i. 



4 SCIENTIFIC CREDIT BEFORE VACCINATION. 

menced practice in the house of his brother, the Rev. 
Stephen Jenner. 

From the time of his return to Gloucestershire down 
almost to the death of Hunter in 1793, Jenner kept up 
a correspondence with the latter. Hunter's letters to 
Jenner have been preserved, and they are, indeed, almost 
the only letters of his that were available for printing 
in his biography. They are a conspicuous feature of 
Drewry Ottley's Life of fohn Hunter} and of the 
earlier chapters of Baron's Life of Edward Jenner, 
There can be no question that Hunter had an unaffected 
liking for his old boarder, who was not only attractive 
to him by his imaginative qualities, but was also good- 
natured, although very dilatory, in getting him speci- 
mens. 

" I don't know any one," Hunter tells him in 1776, " I 
would as soon write to as you. I don't know anybody 
I am so much obliged to." Again, on i8th January, 
1776: "I have but one order to send you, which is, to 
send everything you can get, either animal, vegetable, 
or mineral;" and, on 17th December, 1777: "I am 
always plaguing you with letters, but you are the only 
man I can apply to," — that is to say, for country speci- 
mens and observations. 

After Jenner had been in practice two years (1775), 
Hunter made him an offer, which had been already, 
declined by several. Hunter had a scheme for starting 
a school of anatomy and natural history in London, to 
a share of which venture he was willing to admit some 
one, with the rank of assistant, on receiving a premium 

^ London, 1835. 



JENNER AND HUNTER. 5 

of one thousand guineas down. Jennei* was asked to 
consider whether he was prepared tb come to London 
and to find one thousand guineas. '* I proposed it to 
L [probably young Ludlow] before he left Lon- 
don," says Hunter, "but his father objected, I believe, 
to the money." Jenner naturally objected to the money 
too, and on his declining the offer, Hunter replied that 
he had hardly expected it would suit Jenner. 

Of the various naturalist inquiries which Hunter set 
his country correspondent to work upon, only two came 
to anything. One of these formed the subject of Jenner's 
own paper in \h^ Philosophical Transactions^ some fourteen 
years after, on the "Natural History of the Cuckoo"; 
another yielded a few meagre observations on the 
temperature of hedgehogs in their torpid and waking 
states respectively. There were also some fragmentary 
conclusions about the action of blood and other organic 
manures upon growing plants, in a letter to Banks. 
These, then, were his earlier achievements, which 
Jenner referred to when he wrote to Ingen-housz in 
1 798 : " Truth, believe me, sir, in this and every other 
investigation which has occupied my attention," etc. 

A great part of Hunter's correspondence with him 
relates to the hibernation of the hedgehog. Hunter's 
long memoir on the ** Heat of Animals," etc., was read 
before the Royal Society in two parts, on June 19th and 
November 13th, 1777; for that research he had been 
collecting facts during several years, and had enlisted 
Jenner in the service, especially with reference to the 
temperature of the hedgehog and other winter-sleepers 
in their torpid state. On August 2nd, 1775, he writes 
to Jenner : " I thank you for your experiment on the 



6 SCIENTIFIC CREDIT BEFORE VACCINATION. 

hedgehog ; but why do you ask me a question by the 
way of solving it? I think your solution is just, but 
why think ? why not try the experiment ? " ^ He then 
directs him to repeat all the experiments (as planned in 
detail by Hunter), and they will give him the solution. 
On loth January, 1776, Hunter again writes .-"Have 
you large trees of different kinds that you can make free 
with ? If you have, I will put you upon a set of experi- 
ments with regard to the heat of vegetables. Have you 
any eaves where bats go at night ? If you have, I will put 
you upon a set of experiments concerning the heat of 
them at different seasons ? " On January 22nd ; " You do 
not mention a word about bats " ; and a few weeks later : 
" If you catch any bats, let me have some of them ; and 
those you try yourself, open a hole in the belly, just' 
large enough to admit the ball [of a thermometer] and 
observe the heat there," etc. In May, 1777, he sent 
Jenner a thermometer which he had got made specially 
for the purpose, and on the 6th of July wrote to him 
again with minute directions for using the ivory sliding 
scale attached to it. 

But not even in the second part of Hunter's memoir 
on Animal Heat, which was read on 13th November, 
1777, are the observations forthcoming on the hedgehog 
and bat, which he wanted Jenner to make for comparison 
with his own observations on the dormouse. On the 
23rd November he writes to say that the hedgehogs sent 
by Jenner had arrived, and to ask him to go on observing 
these hibernators in the country. On December 17th 



* This is all the warrant that Baron had in saying that Hunter 
used to advise his pupil, " Don't think, but try.'* 



DILATORY OBSERVATIONS ON HIBERNATION. 7 

he writes to say that the hedgehogs sent had died : 
"therefore I want you to find out their haunts, and 
observe, if you can; what they do," giving him full di- 
rections how to proceed. On 29th March, 1778 : " Have 
you made any experiments with the hedgehogs, and can 
you send me some this spring ? for all those sent me 
died, so that I am hedgehogless." 

In any circumstances it would have been no easy 
thing to carry out Hunter's directions for taking the 
temperature of a torpid hedgehog by making an incision 
in its body when it was coiled up into a ball ; and Jen- 
ner was at that time in no mood for nice researches. 
Having written to tell Hunter of the disappointment in 
love which had just befallen him, he got answer on 25th 
September, 1778: "Let her go, never mind her. I 
shall employ you with hedgehogs." He then puts before 
him a number of points to be observed in the problem 
of winter-sleep, including the autumnal storing of fat, 
and the consumption of it during the winter, none of 
which does Jenner appear ever to have fully appre- 
hended or at all events given heed to. The references 
to hedgehogs go on, in the same tenor, in the letters 
for several years following. In 1783 Jenner wrote for 
a thermometer, whereupon Hunter replied : " You are 
very sly, although you think I cannot see it ; you very 
modestly ask for a thermometer. I will send one, but 

take care those d d clumsy fingers do not break it 

also." 

The sole outcome of all this dunning year after year 
was the brief record of four temperature observations 
made by Jenner on a hedgehog (two in winter, one in 
summer, and one at a season not stated), which Hunter 



SCIENTIFIC CREDIT BEFORE VACCINATION, 



introduced in half a dozen lines into his paper on the 
Animal Heat when he reprinted it in 1786, nine years 
after it was read to the Royal Society, in his " Obser- 
vations on Certain Parts of the Animal Economy." As 
late as loth December, 1791, Hunter writes to Jenner: 
"Now that hedgehogs are gone to sleep, I conld wish 
you would get some of them for me," and send them 
to London. Baron says that he found among Jeuner's 
papers "a manuscript detailing many of the experi- 
ments which he had made at the instigation of Mr. 
Hunter on hedgehogs ; but I deem it expedient to delay 
its publication till it is found convenient to collect and 
print all his medical and philosophical papers." The 
collection referred to was never published. Hunter in 
1786 gave the four temperature-observations that Jen- 
ner had made for him ; and, if there had been any others 
worth recording, it is tolerably certain that Hunter 
would have put them in to eke out his meagre data, 

Jenner's "medical papers," previous to those on cow- 
pox, were one on a mode of preparing tartar emetic, and 
an observation of calcified coronary arteries of the heart 
in a case of angina pectoris, which was used by Dr. 
Parry, of Bath. His "philosophical papers" are repre- 
sented solely by the observations on the cuckoo, in the 
Pkilosophical Transactions for 17SS. The instructive 
history of that piece will now be given, with the view of 
throwing some light on Jenner's habits of thought and 
of work before we come to his more famous labours on 
cowpox. 

A farm near Berkeley belonging to Jenner's aunt 
Hooper was a favourite haunt of cuckoos, and Jenner as 
a boy was familiar, like other boys of the locality, with 



THE PROBLEM OF THE CUCKOO. 9 

the bird and its ways. The fact that it laid its eggs in 
the nests of hedge-sparrows and some other birds had 
been admitted by every one for centuries, having been 
noted as a piece of common knowledge by Aristotle. 
It was reserved for the Philosophical Transactions^ or for 
the Hon. Daines Barrington writing therein, to call in 
question this familiar observation, which men and boys 
had made ever since European cuckoos had been ob- 
served by men and boys at all. 

John Hunter, having no doubt that the common 
experience of mankind was to be trusted in that matter, 
proceeded to ask himself why the cuckoo should lay its 
eggs in the nests of other birds ; and he endeavoured to 
find an answer by his favourite method of examining 
the internal economy, and its adaptation to the animal's 
habits. 

Previous to 177 1, or before Jenner, aged twenty-one, 
came to board with him, Hunter was known to have 
dissected hen cuckoos,^ and had satisfied himself that 
there was nothing in the anatomical disposition of the 
viscera, as some before him had alleged, to prevent the 
bird from sitting on eggs like any other bird. 

This conclusion was one of those which Jenner intro- 
duced as a novelty into his paper of 1788, along with an 
analogical argument identical with that which White 
of Selborne had developed from observations on the 
structure of the cfosely allied fern-owl in a letter to 
Barrington in 1776. But the biographer. Baron, mytho- 
logical as usual, will have it that " all naturalists previous 
to Jenner were inclined to ascribe the peculiarity in the 

^ See Daines Barrington, PhiL Trans.y vol. 62 (1771). 



10 SCIENTIFIC CREDIT BErORE VACCINATION. 

economy of the cuckoo to causes of this kind," namely 
its structural disabihties, the truth being that Herissant's 
conjecture was discredited already. There were many 
other points in the cuckoo's problem needing elucidation, 
as Hunter well knew; and when Jenner left Hunter's 
roof to return to Berkeley, he would undoubtedly be in 
possession of the great anatomist's views and wishes 
on the subject. In one of his earliest letters, written a 
few months after Jenner's return to the country, he 
thanks the latter for sending a cuckoo's stomach; in 
another, of the same period, he writes : " I shall be glad 
of your observations on the cuckoo ; be as particular as 
you possibly can." 

Hunter was by no means disposed to deprive his 
correspondent of any advantage or credit that might 
accrue from his studies in natural history. At an early 
period of their correspondence he had written to him : 
" If in any of these pursuits you discover any principle 
worthy of the public, I will give it to the Royal Society 
for you."' However, Jenner's study of the cuckoo did 
not for years look as if it would amount to anything, any 
more than the observations on the hedgehog ever did. 
In 1783, or ten years from the date of his first cuckoo 
reference, we find Hunter still writing: "I should be 
glad to have a true and particular account of the cuckoo, 
as far as possible under your own eye"; and, in the 
same year; " I request the whole history of cuckoos this 
summer from you." Three years more passed ; and at 
length, in 17S6, Jenner drew up for the Royal Society 
his paper on the Natural History of the Cuckoo, in the 



A DISCOVERY AT THE LAST MOMENT. II 

form of a letter to Hunter. It was sent to the latter, 
who kept It beside him for several months before giving 
It to the Royal Society, as that body was so torn with 
inward dissensions that the moment was not favourable.^ 
In May or June, 1787, the paper came before the 
Council, and was ordered for publication in the Philo^ 
sopliical Transactio7is? 

But Jenner had found reason to change his mind at 
the last moment on the most important part of this 
problem, which he had been at work upon for some fif- 
teen years. He wrote to have his paper returned ; and 
Banks, the president of the Royal Society, acceded to 
his request as follows, under date 7th July, 1787 ^ : — 

" In consequence of your having discovered that the 
young cuckoo, and not the parent bird, removes the 
eggs and young from the nest in which it is deposited, 
the Council thought it best to give you a full scope for 
altering it as you shall choose. Another year we shall 
be glad to receive it again, and print it." 

Having at length got the Prince of Denmark into the 
play, Jenner sent it up, dated 27th December, 1787; it 
was read before the Royal Society on 13th March, 1788, 
and published in the Transactions for that year. On 
the strength of this achievement, Jenner wrote to 
Hunter suggesting that he should be proposed for 
election into the Royal Society ; to which Hunter replied 
that Sir Joseph Banks, on being spoken to, " had not 
the least objection, and will give all his assistance, but 



^ Hunter to Jenner, 26lh April, 1787, Ibid, p. 104. 
' Jenner to Banks, in Baron, i. n* 
■ In Baron, i. ^^, 



l2 SCIENTIFIC CREDIT BEFORE VACCINATION. 

he thinks the paper had better be first printed and 
delivered, and let the people rest a little upon it, for he 
says there are many who can hardly believe it wholly." ^ 
It was accordingly in the February following (1789) that 
Jenner was balloted for and elected F.R.S. 

The paper on the cuckoo, in its original form, con- 
tained a number of observations on the contents of the 
stomach in the young bird, on the small relative size 
of the cuckoo's egg (which was apparently not known at 
the time to Gilbert White), on the fierce behaviour of 
the young cuckoo when inspected in its nest, on the 
fiumber of eggs or traces of eggs in the cuckoo's oviduct, 
and on the hedge-sparrow's or other foster- pa rent's 
habit of ejecting its own eggs from the nest after the 
cuckoo's had been deposited therein. Besides these 
observations, and one or two rather crudely devised ex- 
periments, the original paper had contained a speculation 
on the causes of the cuckoo not hatching and rearing its 
own young. 

The basjs of that theory was the observation on the 
number of eggs in the cuckoo's ovary in various stages 
of forwardness. Gilbert White, in his letters to Bar- 
rington, had already questioned the statement that the 
cuckoo lays only one egg, and proposed to examine 
the ovarium so as to settle the matter. That was what 
Jenner did. He found it like a hen's ovary, with eggs 
in all stages, and he concluded, as White said he would 
do if the fact were so, that the cuckoo laid "a great 

' The following judicious puff was inserted among the leading 
paragraphs of the World newspaper for 8th April, 1788 : "The 
Iv'aturat History of the Cuckoo, lately read to the [Royal] Society, 
is one of the happiest additions to this part of animated nature." 



THE cuckoo's instinct, 1 3 

number of eggs " in each year. Jehner's notion was 
that the cuckoo had "a call of nature to produce a 
numerous progeny"; and was also " compelled," for some 
reason not stated, to leave us early, being only " allowed " 
a short residence, and " instinctively directed " to migrate 
in July. It could only reconcile those two calls of 
nature by laying eggs up to the end of its stay and 
leaving them to be hatched by other birds. 

The point that later theorists have dwelt upon is the 
(assumed) long interval between each of the cuckoo's 
^ggs ; it is that, and not the mere number of the eggs, 
which would " make the process of laying and hatching 
inconveniently long," as Darwin says [Origin of Species^ 
6th ed., p. 212), and would create also the inconvenience 
of eggs and young birds of different ages in the same 
nest. To entrust each egg, as it was laid, to the care 
of some other bird then sitting (and, as Gilbert White 
pointed out, another bird wisely chosen) would thus 
be a true maternal instinct, or an action done for the 
sake of the young brood severally and collectively. 
But the cuckoo's early migration can hardly be part of 
the cause ; it is rather a correlated effect. The cuckoo 
leaves us early because its parental instincts or duties, 
as it construes them, do not serve to detain it The 
young cuckoos do themselves remain until compara- 
tively late in the year (September), or until they are 
strong enough to undertake their flight. What cuckoos 
of the first year could do, the same birds in their second 
and subsequent years could surely do also. 

The after-thought which caused Jenner to ask for his 
paper to be returned to him formed that part of the 
communication, as published in the Philosophical Trans^ 



14 



SCIENTIFIC CREDIT BEFORE VACCINATION. 



actions, which Banks must have had in his mind when 
' he told Hunter that "there are many who can hardly 
' believe it wholly," It is a highly coloured description 
I of a young cuckoo, hatched since the day before, as seen 
1 the act of ejecting its fellow-nestling, a young hedge- 
sparrow of its own age and size. Jenner's original view, 
based on observations and abundantly confirmed, was 
that the old hedge-sparrow turned out her own eggs 
from the nest after the cuckoo's was laid beside them, 
on the principle, perhaps, of cutting off its nose to spite 
jts face ; and that the old cuckoo somehow came and 
turned out the hedge-sparrow's brood after they were 
hatched. Such, at least, is the view that Banks professes 
to have read in the first edition of the paper; and that 
is a view which Jenner himself speaks of, in the second 
edition of it, as being erroneously held by some authors, 
although he does not say that he himself had held it 
until quite recently. The common-sense view, which 
he also refers to, was the one given some years before 
by Pennant in his British Zoology} to the effect that 
the young cuckoo, growing much faster than the com- 
panion fledglings which started level with it, and soon 
I requiring all the room, destroyed the young hedge- 
sparrows by overlaying them. {Their ejectment after 
that would be a matter of course, and would naturally 
be done by the old bird.) 
But on the 19th of June, 1787, Jenner saw a mar- 
vellous thing happen. The day before, a hedge-spar- 
row's nest had contained one cuckoo's egg and three of 
the bird's own eggs. Next day, the nest contained 
' Fourth 



1776,1 



* 



A WONDROUS TALE. IS 

the newly hatched cuckoo (from an egg the size of a 
lark's) and one newly hatched hedge-sparrow, the two 
remaining eggs having disappeared. " The nest was 
placed so near the extremity of a hedge that I could 
distinctly see what was going forward, and saw the 
young cuckoo [less than a day out of the shell] in the 
act of turning out the young hedge-sparrow. The little 
animal, with the assistance of its rump and wings, con- 
trived to get the bird upon its back, and clambered 
backward with it up the side of the nest, till it reached 
the top, where, resting for a moment, it threw off its, 
load with a jerk, and quite disengaged it from the nest 
It remained in this situation a short time, feeling about 
with the extremities of its wings as if to be convinced 
whether the business was properly executed, and then 
dropped into the nest again. With these (the ex- 
tremities of its wings) I have often [how often ?] seen it 
examine, as it were, an egg and nestling before it 
began its operations ; and the nice sensibility which 
these parts appeared to possess seemed sufficiently to 
compensate the want of sight, which as yet it was 
destitute of** — being, in fact, a raw young thing hardly 
bigger than the small egg which held it the day before. 
He afterwards tried the experiment of putting in an egg 
beside this heartless young creature, when, ** by a similar 
process, it was conveyed to the edge of the nest, and 
thrown out.*' These experiments he had since repeated 
several times in different nests, and always found the 
young cuckoo " disposed to act in the same manner," 
The *' often " in a former sentence, and the " several 
times in different nests " in the last sentence, must 
not be taken too literally, inasmuch as this whole be- 



SCIENTIFIC CREDIT BEFORE VACCINATION. 



haviour of the young cuckoo was, on his own admission; 
new to him on the 19th of June, 1787, by which time 
the hatching season was about over for that year, and 
his paper was sent in and printed before another season. 
But these were not the only marvels introduced into 
the paper on second thoughts. The young cuckoo's back, 
it seems, is specially designed for the lodgment and 
ejectment of eggs and young birds ; " for, different from 
other newly hatched birds, its back from the scapulse 
downwards is very broad, with a considerable depression 
in the middle. This depression seems formed by nature 
for the design of giving a more secure lodgment to 
the egg of the hedge-sparrow, or its young one, when 
the young cuckoo is employed in removing either of 
thera from the nest. When it is about twelve days old, 
this cavity is quite filled up, and then the back assumes 
the shape of nestling birds in general." This unique 
and marvellous structural change, it need hardly be 
said, has no existence ; nor did Jenner seek to establish 
his assertion in the only way by which it could be 
established, namely, by a series of dissections. More- 
over, he himself inadvertently supplies the key to the 
illusion and the fanciful anatomy by his remark on 
the previous page of his wondrous tale of ejectment, 
that the young cuckoo " makes a lodgment for the 

I burden by elevating its elbows." 
Not only does the peculiar structural depression dis- 
appear from its back after the twelfth day; also "the 
disposition for turning out its companions begins to 
decline from the time it is two or three till it is about 
twelve days old, when, as far as I have seen, it ceases. 
Indeed, the disposition for throwing out the egg appears 



I 



ACCEPTED BY ORNITHOLOGISTS. \^ 

to cease a few days sooner ; for I have frequently seen," 
etc. 

All this varied, rich, and marvellous experience of the 
behaviour of young cuckoos has to be crowded into a 
few days at the end of the breeding season of 1787, 
having eluded the observer's notice during all the years 
since 1773, when he first wrote to Hunter about his 
"observations on the cuckoo." Hunter's advice to him 
on that occasion was, " Be as particular as you possibly 
can " ; and never was the advice more needed. 

Jenner's graphic description of the newly hatched 
cuckoo clambering up the side of the nest with a young 
hedge-sparrow as big as itself in a specially designed 
hollow of its back, balancing itself on the edge of the 
nest, then throwing its burden over the precipice with an 
adroit jerk, and remaining there a short time to make 
sure that the catastrophe was complete, has been ac- 
cepted by all ornithologists.^ Pennant, who had origin- 
ally given the sensible explanation that the young 
cuckoo " quickly destroys the genuine offspring by over- 
laying them, as its growth is soon so superior," altered 
the passage in his edition next following Jenner's paper 
to ** quickly destroys them by ejecting them from the 
nest." Jenner's cuckoo paper contains a few credible 
and prosaic facts ; but the greater part of it, and all that 
part of it which is best remembered, is a tissue of incon- 
sistencies and absurdities. 

This, then, was the piece of scientific work which got 

^ Darwin {Origin 0/ Species y etc., 6th ed., p. 214) says that Gould 
had " received a trustworthy account of a young cuckoo," etc., but 
he does not quote Jenner, the sole authority for the " strange and 
odious instinct.'' 



1 8 SCIENTIFIC CREDIT BEFORE VACCINATION. 

Jenner elected into the Royal Society ; and this was 
chiefly what he had in mind when he wrote to Ingen- 
housz at the outset of the cowpox controversy : " Truth, 
believe me, sir, in this and every other physiological 
investigation which has occupied my attention, has ever 
been the object which I have endeavoured to hold in 
view." 



CHAPTER II. 

THE POX, THE SMALLPOX, AND THE COWPOX. 

WHEN Jenner came up to London in- 1788 or 1789 
in connexion either with the reading of his 
cuckoo paper before the Royal Society, or with his 
election into that body, he brought with him a drawing of 
a peculiar affection on the hand of a dairymaid ; namely, 
a large bluish-white bleb about the size of a silver three- 
penny piece. The drawing was shown to the various 
old friends whom he met in town, including Banks, Home, 
and Hunter ; a rough sketch of the tumid bleb of a cow- 
pox sore exists among the Hunterian drawings on the 
envelope of a letter from Jenner without date.^ It was 
a pathological curiosity in London, but a tolerably 
familiar thing in the dairy farms of Dorset, Wiltshire, 
Gloucestershire, Norfolk, and other counties. Some of 
Jenner's professional neighbours knew a good deal about 
it, particularly Mr. Fewster, of Thornbury. Jenner him- 
self at that time knew hardly anything more about it 
than he might have heard now and then ; and, in truth, 
the milkers* sores were more likely to be treated, if 
treated at all, by a cow-leech than by a surgeon. But 
Jenner's fancy had been arrested by some idle talk that 

^ Ottley^is Life of John Hunter, p. 39. 

»9 



20 THE POX, THE SMALLPOX, AND THE COWPOX. 

he had heard of cowpoxed milkers being unable to take 
smallpox ; he thought he saw before him the materials 
for another Royal Society paper, and he kept cowpox 
in mind in the lazy and unmethodical way that was 
natural to him. 

The cowpox had been so called as far back as the 
oldest inhabitant could remember, Jenner himself says 
** from time immemorial." ^ It had not occurred to any 
one to associate it in any way with the smallpox until 
rather late in the eighteenth century ; and those who did 
connect the two would appear to have been rather the 
idle gossips than those country people who had some 
real practical knowledge of either or both diseases. 
The single bond connecting cowpox with smallpox was 
the occurrence of the word " pox " in each name ; it was 
a case of the river in Macedon and the river in Mon- 
mouth. The jingle of the names had the effect that it 
often has upon credulous people, whose acquaintance 
with any matter is more verbal than real. Those who 
had been unlucky enough to catch the cowpox on their 
fingers from milking cows with sore teats had an in- 
stinctive notion why the affection had been called a 
pox ; but the officious gossips who knew no more than 

^ The Origin of the Vaccine Inoculation, \2>oi. In th^ Inquiry 
he says that the oldest farmers knew it by the name of cowpox as 
far back as they could remember, but it had not occurred to them 
to connect it with smallpox. Jenner's Inquiry^ although it counts 
among the sacred books of the profession, is not much read now, 
even by the officials whose business is with these matters. Thus, 
a former Superintendent of Statistics for Scotland (Dr. Stark), in 
his report for 1870, p. 32, deplores the ignorance of the pubHc about 
vaccination, and begms a homily to them with the remark that it 
was Jenner who first called the infection " cowpox." 



THE COWPOX LEGEND LOCALISED. 21 

the name of the thing must needs make a fine romantic 
legend out of it. You have had the cowpox, they said 
to the milkers ; therefore you cannot take the smallpox. 
It is a mistake to suppose that this now famous 
legend had been a slow growth, with its roots deep 
down in experience. It was by no means universal in 
the grazing districts of England where cowpox was 
found ; Mr, Jacobs, a prominent Bristol solicitor about 
Jcnner's time, came forward to testify that he had twice 
suffered from cowpox sores when he was a "lad working 
upon his father's farm some forty years before, but he 
had never heard it said that the cowpox kept away the 
smallpox.^ Dorsetshire is known to have been one in- 
digenous source of the cowpox-smallpox legend about 
the year 1774 or earlier ; but it is not impossible, and, 
if we may trust the evidence collected by Pearson (Nov., 
1798), it is probable, that a corresponding legend may 
have sprung up independently, and through the opera- 
tion of the same legend-making causes, in other English 
dairy-farming districts. Those who professed to have 
discovered the same country legend in remote parts of 
Europe, such as Holstein and Provence, after Jenner's 
writings had become universally talked about, do not 
seem to have allowed for the possibility of its having 
been a mere after-thought on the part of their not very 
discriminating informants.' In several of these foreign 



' ConlribuHons to Physical and Medical Knowledge, edited by 
Beddoes. Bristol, 1799, p. 420. 

' For an account of the Holstein cowpox and the legend, see the 
summary of essay by Hellway, in Hufeland's Biblioihek der prac- 
tischen Heilkunde, 1801, Hellway was the author who first in- 



F22 THE POX, THE SMALLPOX, AND THE CmVPOX. 

versions, it is shcep-pox that figures prominently, a dis- 
ease of the cattle being but vaguely hinted at,' One 
Germanof credit, Dr. Heim, of Berlin, who performed the 
first vaccinations in that capital, distinctly tells us that 
he had in his youth heard from his father of milkmaids 
catching sores on their hands from the cows' teats, but 
there had been no mention of protection against small- 
pox.- In France they had no name for cowpox at all, 
and therefore no basis for the legend. The stories 
about deliberate cowpoxing in Beloochistan and the 
Peruvian Andes are hardly to be taken seriously as 
evidence of the world-wide prevalence of a legend de- 
pending upon the jingle of words, which Jenner dragged 
from obscurity in the western counties. Even in the 
eastern counties, where the affection was called pap- 
pox, the legend of protection from smallpox was not 

I indigenous before Jenner. 

The origin of the legend is not difficult to account 
for. The notion of warding off, antagonizing, or charm- 
ing away disease is old enough, and has pervaded the 
medical beliefs of the learned as well as of the vulgar. 

' The special fitness of the charm or antidote depended 
usually upon some verbal jingle. The old herb-books 

L are full of fanciful nonsense of the kind. Thus it af- 

t forded protection from a mad dog to carry the herb 



I Tcnled the four spurious varieties ("yellow pox," "black pox," 
" white pox," etc.). 

' It was so in the disease near Monlpellier in 1781, vaguely re- 
I ported by Rabaut, a Protestant pastor, and claimed long after, in 
1821, by Husson (Did. des Sc. Med., art. " Vaccination ") as the 
I true source of Jenner's cowpox ideas. 

' Hufeland's Jounial, voL x. pt. 2, p. 187. 



A JINGLE OF WORDS. 23 

hound's-tongue in a packet tied to the wrist ; and the 
root of the dog-rose was an antidote to the dog*s bite.^ 
The supposed antagonism of cowpox to smallpox was a 
verbal jingle of that kind ; it was founded on the simi- 
larity of names, and not on any alleged likeness between 
the two diseases. Certainly for those who knew by 
inspection what the pox of the cows' teats was, and 
most of all for those who had suffered the painful and 
often obdurate ulcers on their own hands, there would 
be no suggestion of real likeness to smallpox, or of the 
one disease being in any way related to the other. It 
was the jingle of the names that brought the two to- 
gether in the first instance. 

The next step in the growth of the legend was also 
made on the part of the illiterate country people. After 
the middle of last century most persons in England 
knew the object of being "cut for the smallpox " ; it 
was thought better to be cut for the smallpox at one's 
own convenience than to run the risk of catching the 
disease when it was epidemic. In the year 1774^ it 
occurred to Benjamin Jesty, a Dorsetshire dairy-farmer 
in good circumstances, that it would serve as well to be 
cut for the cowpox ; and accordingly he himself did 
actually cut his wife and two children for that disease ; 
that is to say, he inserted the matter of it from a cow's 
sore teats into their arms by incisions. What followed 



^ Gaidoz, La Rage et St, Hubert, Paris, 1887. Chapter i. § 2. 

^ This date is assigned to Jesty's experiment in the record of the 
fact on his tombstone in the churchyard of Worth Matravers. 
Jesty was made a good deal of by the vaccinists who separated 
from Jenner in 1 801-2, and had his portrait painted for the Vaccine 
Pock Institution. He died in 1816. 



24 THE POX, THE SMALLPOX, AND THE COWPOX. 

IS not precisely known, except that the doctor had 
be called in ; but it does not appear that Jesty's odd 
freak found any imitators. However, when so much was 
being heard on every hand about preventing the small- 
pox by inoculation of mild varieties of itself, such as 
the absurdly named swinepox, the fancy about cowpox 
was pretty sure to be mentioned here or there. It was 
in some such casual way that Jennor first happened to 
learn of the existence of the legend. For some years 
he contented himself with sounding hts professional 
colleagues about it, introducing the topic now and then 
at their convivial meetings at country inns. The man 
who knew most about cowpox sores in milkers was 
Fewster, of Thombury ; and Fewster, as well as others, 
had unfortunately good reason to scout the milker's 
protection from smallpox as an old wife's fable. When- 
ever Jenner proceeded to air his fancy, he was met with 
instance after instance in which a cowpoxed milker had 
been attacked by smallpox like the rest.' It was clear 
that the legend as it stood would not work. 

We have all heard how Jenner rose superior to diffi- 
culties, and how he resolved not to be baffled ; but few 
persons know what the difficulties were, and how he set 
about circumventing them. The way was barred by the 
hard facts of experience, which country doctors, who 
knew far more of cowpox than Jenner did, recognised 
in the way that sensible men always do recognise 
hard facts, Jenner, however, thought that he saw an 
opportunity of repeating the success of his cuckoo paper 
at the Royal Society. As may be seen from his preface. 



VERBAL KNOWLEDGE AND REAL. 2? 

the tasl; that he assigned to himself was to reduce a 
piece of rustic lore to scientific precision. It is highly 
improbable that he would have ever undertaken the 
subject, or persevered with it, if he had been as familiar 
with the nature of the cowpox, whether in cows or in 
milkers, as some of his medical and veterinary neigh- 
bours were. But his knowledge of the affection does 
not appear to have been more than an acquaintance 
with the name and the common talk, and with the 
superficial character of the milkers' sores. One can 
readily understand Jesty, the Dorset farmer, being 
misled by the similarity of names, and by superficial 
aspects of diseased processes. If we are to acquit 
Jennerof a much graver charge, we shall have to assume 
that he had no deeper insight into the real nature of 
cowpox, or the real significance of the name which it 
had borne for generations, than had Jesty himself. 
Jenner was, indeed. Just the loose-thinking, imaginative 
sort of person to deal with the matter in a merely verbal 
way. While his prosaic medical neighbours saw no 
point of contact between cowpox and smallpox, and 
while they gave due heed to the abundant experience 
that cowpoxed milkers had not escaped the common 
epidemic of the time, Jenner persuaded himself that the 
one-kind of pox was somehow related to the other, that 
there was a scientific or pathological basis for the 
rumoured antagonism between them, and that the cases 
of smallpox in previously cowpoxed milkers must have 
been exceptions which he would one day be able to 
account for. 

Meanwhile let us see why cowpox had been so called 



26 THE POX, THE SMALLPOX, AND THE COWPOX. 



by the common people long before Jenner's time, and 
also why the variolous epidemic which had come across 
Europe from the East had been named smallpox. We 
can at the present day deal with these pathological and 
philological questions more easily than Jenner's contem- 
poraries could ; but we can hardly have a stronger or 
better founded conviction than they had that, whatever 
the similarity of names depended on, the diseases them- 
selves were totally unlike. It was just because Jenner 
had no profound sense of these empirical realities that 
he went blundering into visionary nonsense in the first 
instance, and at length into systematic mystification and 
chicane. 

The first known occurrence of the name "small 
pockes " in English writings is in HoHnshed's Chronicle 
(1577), under the year 1366, where it is applied to 
an epidemic called pestileiitia and lues by Polydore 
Virgil. An epidemic of /^.fj^/j in England in the latter 
part of the reign of Edward III. meant. In all proba- 
bility, pestis in its technical sense of the plague. It 
seems to have been a yerbal blunder of Holinshed to 
translate it smallpox ; at all events, he gives no reason 
for departing from usage. But HoHnshed's use of the 
word, although made in error, is evidence that smallpox 
was known by name in English speech in the Eliza- 
bethan period. It is not improbable, indeed, that the 
word was known in England before the thing itself 
' became at all familiar ; it may very well have been a 
direct importation into the language of the French /^^iVe 
v^role} which is the only other European name of the 



I 



ORIGIN OF THE NAME "SMALLPOX." 2/ 

disease constructed on the same lines. There is every 
reason to think that France had an earlier experience 
of smallpox epidemics than England had ; there were 
epidemics of it in Paris in 1536 and 1568, and over 
France generally in 1577 ^^^1 1586 ;i and, if we are to 
be guided by facts as chronicled, and not by vague pre- 
possessions as to the ancient and universal prevalence 
of smallpox, these were the first epidemics of the disease 
in France. For the same period there is absolutely 
no record of the disease being epidemic in England, 
although it is probable from Holinshed's curious mis- 
translation of the pestis of two hundred years before as 
" small pockes," that the disease was being spoken of in 
England in 1577, which was the very year of a great 
epidemic all over France, and that the name in England 
was a direct adoption oi petite v^role. 

There may, of course, have been cases of smallpox 
in England at an earlier period, although that is hardly 
to be inferred from the mere use of the word variola by 
mediaeval English compilers on medicine ; the compilers 
all copied from each other or from some common 
Galenic-Arabistic source, their dealing with diseases 
being purely verbal, so much so that a confused 
observer and empiric practitioner like John Ardern 
stands out as a brilliant figure because he describes 
from nature. It is known, however, that smallpox 
cases did occur in London in the first years of the 17th 

says that petite was prefixed to vdrole in France "about the 15th 
century." But it appears to have been only in the last years of 
that century that virole itself came into use. See also Littr^, Diet, 
de la langue Frangaise, art. " Vdrole." 

^ Bohn, Handbuch der Vaccination, Leipzig, 1875, p. 7. 



28 THE POX, THE SMALLPOX, AND THE COWPOX. 



century, although probably not in great numbers. The 
London bills of mortality were published by Captain 
John Graiint^ from 1629 onwards ; there is no authentic 
record for earlier years, but even in that year, and for 
several years after, the deaths from smallpox are a mere 
trifle, except during the not very severe epidemic out- 
bursts which came at intervals. It is not until 1667 
that the total of deaths from smallpox in London 
becomes a large one every year.' That was the small- 
pox period which Sydenham lived through, and it 
seems reasonable to conclude that he was the first 
English writer on smallpox chiefly because he was the 
first who saw the disease on the great scale. 

But the French had their I'l'rok before they had their ^ 
petite v^role, and the English had their pox before they 
had their smallpox. The sequence is made clear not 
only by the philology but also by the history. Syphilis, 

I or the pox, overran all Europe as a strange and un- 
familiar epidemic in the years 1494 to 149S, and con- 
tinued with almost unabated virulence until about 1520. 
The names of the strange malady fluctuated for a 
time, and were various. In a proclamation of James 
IV. of Scotland, 22nd September, 1497, with reference 
to isolating the infected in Edinburgh to the island of 
Inch Keith, the disease is spoken of by the French 
name of Grandgor, "and the greit uther Skayth."' 
3r( 
: 



' Niitii rdl and Political Observations upi 
3rd ed. London, 1665. 

= See the Tables compiled by G^y, Jour/ 
1882, p. 430. 

' From records of Town Council of Edinburgh, 



: the Bills of Mortality, 
Statist, Sec. London, 



ORIGIN OF THE NAME "POX." 29 

But in France the name was soon fixed as vSrole^ and 
in England as pox. Thus in a petition of Simon Fish 
to Henry VIII., in 1530, against Romish priests, "the 
Pockes " is the term used.^ The name had become a 
by-word in Shakespeare's time, and was clearly used 
with reference to the opprobrious disease that had been 
known in the country for a century. If it was now and 
then used for the smallpox in the 17th century, it was 
only a brief aberration from the common usage. A 
current notion of the present day, that "the pox" 
originally meant the smallpox, depends upon a curious 
error which I shall deal with in a note.^ 

^ " These be they that corrupt the whole generation of mankind 
in your realm, that catch the Pockes of one woman and bear them 
to another,^' etc. Cited by Beckett, Phil. Traws, xxx. (17 18), 
p. 845. In Fabyan's Chronicle^ which is supposed to have been 
written not long before his death in 15 12, it is stated (Ellis's edition, 
p. 653) that Edward IV., during an expedition against the Scots 
in 1463, "was then vysyted with the syknesse of pocky s." Of 
course the name given to the king's malady by Fabyan is of no 
value as diagnosis ; but he would hardly have used the word at all 
if it had not been then in men's mouths, as it well might be in the 
very years of his writing, the disease, which was certainly called 
'*the Pockes" in 1530 (as above), having invaded England about 

1495-7. 
2 In Webster's, Todd's, and other dictionaries it is stated that 

pox formerly meant the smallpox, and " was often employed in this 
signification in imprecations and exclamations." This absurd 
error is traceable to a note by Dr. Farmer, the commentator on 
Shakespeare. In Lov^s Labour's Lost, v. 2, a lady in waiting ex- 
claims, " A pox of that jest ! " whereon Theobald remarks that the 
language is unbecoming in a lady. Farmer replies, " But there 
needs no alarm — the smallpox only is alluded to," inasmuch as the 
jest to which the lady replied was, " Oh that your face were not so 
full of O's ! " le,y pitted with the smallpox. Even if that be the 



30 THE POX, THE SMALLPOX, AND THE COWPOX. 

The lues venerea was called in English the pockys, 
pockes, or pox for a reason that the student of its 
history finds no great difficulty in making out, although 
the name cannot but seem inappropriate to those who 
have heard of the disease only in its modern forms. A 
striking character of the great epidemic which began in 
1494 was the general eruption on the skin; in some of the 
contemporary accounts that eruption (now reckoned a 
"secondary") overshadows all else in the disease. The 
contemporary accounts were collected in two volumes 
published at Venice by Luisini in 1566.^ In another 



I 



meaning, it was a special conceit for the occasion, or a play upon 
the well-known ordinary Shakespearian use of the word. Farmer 
supports his comment by two references to contemporary usage. 
Davison, he says, has a canzonet "on his lady's sickness of the 
poxe." Now, in allthe three editions of Francis Davison's Poetical 
V^a^jorfi'f, published in his lifetime (1602, 1608, and i5ii),the title of 
the poem is "Upon his Ladies sicknesse of the Small Pocks'' ; but 
in a pirated and careless reprint of 1621, from which Farmer had 
quoted, the word "small" is omitted by the printer, and the 
name of "Th. Spilman" is also omitted from the foot of the 
poem, so that Farmer assigned it to Da\-ison, although that poet 
had been careful to distinguish it, along with poems by Sir John 
Davies and others in his volume, from his own compositions. 
That Davison knew the correct use of the French terms also, is 
clear from the heading to his translation of an epigram by Martial, 
about drinking out of the same glass — " A Monsieur Naso, 
vdrol^." Farmer's other reference is to an undoubted use by Dr. 
Donne, in a letter to his sister, of the Pox for the Smallpox. I 
have found another similar usage by Donne in a letter to Sir R. 
D., in which he says of " my L. Harrington," that " now they know 
all his disease to be the Pox, and Measels mingled." But Donne's 
7th century abbreviation is exceptional, and never became estab- 
lished. 

De tnorbo Gallico, 2 tom. 



Venetiis, 1566. 



WHY THE rOX WAS SO CALLED. 3 1 

"e»F them (by Le Maire) we read that the disease in 
Savoy was called " la clavela," from the eruption of hard 
knots, pimples, blebs, etc., on the skin, la daveh'e being 
the modern French name given to smallpox of sheep 
for the same reason. In the monograph by Nicholas 
Massa, of Venice, which was long regarded as the most 
authoritative, although Hensler questions its value as 
first-hand testimony,' pustidm diversm et alits infectiones 
aitane<E is the first line in his formal definition of the 
disease. In his fifth chapter, devoted to the Pustules, 
he says they occurred over the whole body — on the 
limbs, on the face and head, and amongst the roots of 
the hair. In his particular description we find such 
terms as elevated, tumid, moist ; red, livid, whitish ; 
small, dry, itching ; broad, flat, soft. They came out 
comparatively early in the disease (second or third week 
even), and their outbreak was often the signal for the 
notorious pains in the head and limbs to abate. In 
many of the cases the pustules overshadowed every- 
thing else to such an extent that no primary lesion was 
thought of. It is clear that Massa thought the disease 
was of the nature of an eruption ; and it is that 
theoretical bias which in part leads Hensler to distrust 
his account. But the term pustul<z is used by the con- 
temporary writers generally;^ from whom wo learn also 
that the " pustules " broke and became foul, corroding 
or eating sores, that warty excrescences grew from the 
floor of the latter, and that fatal bleedings sometimes 

I GesdiichU der Liislseuclie, Part I., 1783, p. 131. 

' See the excellent summary of facts relating to the skin affec- 
tion of the great epidemic in Haser's Geschichte der Med. u. epid. 
Krankh., vol. iii. pp. 264 7, 3rd ed, Jena, 1882. 



M 



32 THE POX, THE SMALLPOX, AND THE COWPOX. 



occurred from the sores about the face. It may be 
conceded that the same term {pitstulir) was applied 
also to the primary lesions, and that much of the 
description relates to the latter; but the occurrence 
oS. puslultB mala per toium corpus is too explicitly and 
circumstantially stated to be held in any doubt. 

The secondary exanthem of the disease, as we now 
know it, is all that represents that terrible feature of the 
great epidemic ; it was the original pustules on the skin 
that gave it its French name of virole and its English 
name of pox. Therefore, when a disease of entirely 
different antecedents and pathology came into common 
notice, — namely, the contagious pustular skin disease 
which had been known in Arabia and the East for 
centuries, and in Europe bore the medieval Latin name 
of variola} — it was called the lesser pox or the small- 
pox, because it had as its obvious feature an outbreak 
of true pustules resembling in their common and 
loathsome aspect, although by no means in minute or 
distinctive characters, those so-called piistultE which 
had been the most obvious feature, especially on the 
face, of the great epidemic that first became notorious 
as syphilis, having determined the colloquial name of 
the latter.' In the subsequent history, syphilis lost its 
more horrible forms of skin eruption, but it retained in 
England its colloquial name of pox, which had a literal 



' Used in that specific sense, it is said, first by Constantinus 
Africanus, who brought the Arabian medical teaching to Salerno 
about 1060. 

J Beckett {Phil. Trans, xxxi. p. 56) says, " Great Pockes or 
Pustules on the surface of their bodies, from whence the Pox is 
denominated." 



WHY THE COWPOX WAS SO CALLED, 33 

meaning only with reference to the original ** pustular" 
type of its secondary on the skin. The pox, or a pox, 
meant from the first what it still means ; it did not as a 
rule mean variola unless it were qualified as the small- 
pox or lesser pox. 

Accordingly, when common usage in the dairy districts 
of England gave the name of cowpox (at what precise 
date is not known) to a certain typical or characteristic 
malady of the cow's teats, that name was given in 
respect of certain well-understood " pocky " characters, 
in the Shakespearian sense of the word,^ — the foul, 
ulcerative, and corroding character of the sores on the 
teats, and their contagious property. It is, indeed, by 
no means unlikely that it was the sores acquired by the 
milkers from handling the teats which first led to the 
affection being named at all ; and there can be no doubt 
that common usage had fixed upon the salient characters 
and had recognised the true affinities of the malady 
when it named it a pox, although it had none of the 
opprobrious associations of the classical name. Cowpox 
was the pox of the cows* teats, which milkers were liable 
to catch ; in Norfolk the name was pap-pox. Its cir- 
cumstances and mode of production are perfectly simple, 
and will be stated afterwards in the unpretending 
language of a Gloucester cow-doctor of Jenner's time 
(chap. iii. p. 56). 

This disease was fancifuUy represented as an amulet 
or charm against smallpox, by the idle gossip of 
credulous persons who listened only to the jingle of the 
names. The milkers themselves must have had the 

^ As in Hamlet, Act v. Scene i, ist clown. 



34 THE POX, THE SMALLPOX, AND THE COWPOX. 



hard teaching of experience and the light of common 
sense to keep their credulity in check, while the medical 
men who were called to treat the milkers' sores, as well 
as the cow-doctors, would be puzzled to see where the 
resemblance to smallpox came in. A fancy of that 
kind could not exist along with real, even if empirical, 
knowledge of the two diseases, let alone the frequent 
experience that cowpoxed milkers could be inoculated 
with smallpox, or could catch smallpox like other 
persons. The fancy was the result of a merely notional, 
nominal, or verbal dealing with the matter. The kind 
of apprehension hardly deserves even to be called 
notional ; for, to a pathologist or epidemiologist, it is as 
truly nonsense to speak of cowpox becoming smallpox 
as it is legitimate nonsense to prove that a horse-chest- 
nut is a chestnut horse- 
It was reserved for Dr. Jenner to take up that sur- 
prising legend, and make it scientifically passable, de- 
spite the impatience and ridicule which his prosaic 
medical neighbours in the cowpox districts had met it 
with. It is difficult to acquit Jenner of recklessness, or 
of culpable laxity, even in the very inception of his idea. 
There is just one thing that may be pleaded as having 
misled him in an excusable way, and that is the form of 
vesicle which cowpox assumes in the first few days of its 
development on the milker's hand. We know now, 
since the experiments of Ricord, Henry Lee, and others, 
that a sore of the pox proper, or of syphilis, when in- 
oculated on the skin, begins in the same kind of whitish 
vesicle as the milker's cowpox, and that the classical 
pox and the cowpox are in that, as in other respects, 
closely parallel (see chap, v. p. 1 19). Jenner was with- 



I 
I 



FIRST TRACES OF JENNER'S INQUIRY. 35 

out these modern aids from experiment to keep him 
right, although his earliest critic, Moseley, saw quite 
clearly, in 1798, "solely on the ground of analogy 
and pathology," that cowpox was the lues bovilla, and 
that smallpox and cowpox were " radically dissimilar." 
.But the mere common sense of the case, the obvious 
concurrence of evidence, the intuitive synthesis, the 
simple pointing of plain facts, would have kept him 
right, if he had not been caught up into a seventh 
heaven of verbal illusion. 

The fact that Jenner carried a drawing of a milker's 
cowpox vesicle to London in 1789, is the first good 
evidence of his interest in the matter. Hunter's corre- 
spondence with him, which went on some two or three 
years beyond that date, contains no reference to cow- 
pox ; and there is no reason to suppose that Jenner 
dealt with this new subject otherwise than in the 
haphazard and indolent way in which he had dealt with 
the cuckoo problem, the hibernation problem, and the 
migration of birds.^ From the year 1789, when he had 
got so far as a drawing of a milker's sore in its vesicular 
stage, there is nothing more heard of cowpox until 1794, 
in which year Jenner would seem to have been rather 
full of the subject. He spoke of it in his correspondence 
with Cline,^ who mentioned it to Joseph Adams, one of 



^ He had promised a paper for the Royal Society on the Migra- 
tion bf Birds ever since 1787. It was printed posthumously in the 
Phil. Trans., voL 114 (1824). It is a rambling, rhetorical discourse 
of no scientific value. Baron gravely tells us that Jenner " ascer- 
tained the laws which regulate ihe migration of birds " {Life, vol. i. 
p. 118). 

2 Cline to Jenner, nth Aug., 1796, in Baron i. 134. 



36 THE POX, THE SMALLFOX, AND THE COWPOX. 

the Hunterian set, who made a reference to the supposed 
antagonism of cowpox to smallpox in the first edition of 
his Morbid Poiso7is (1795), without mentioning where 
the idea had come from. He spoke of it also in con- 
versation with his intimate, the Rev. Dr. Worthington, 
who wrote of Jenners speculations to his correspondent, 
Dr. Ha37garth, of Chester, a medical celebrity of the 
time. Haygarth's reply (iSth April, 1794) is interesting : 
" Your account of the cowpox is indeed very marvellous, 
being so strange a history, and so contradictory to ail 
past observations on this subject^ [that] very clear and full 
evidence will be required to render it credible. . . . 
I trust that no reliance will be placed upon vulgar 
stories." It is proof, also, of the prevalence of a certain 
amount of talk on the matter in medical circles in the 
west country, that Dr. Beddoes, the leading practitioner 
in Bristol, should have made a passing reference to it 
among the " Queries respecting Inoculation," which he 
appended to the translation (London, 1795) of the 
Spanish treatise on Femoral Hernia by Gimbernat. 

It was not until May, 1796, that Jenner took the first 
step to give effect to his ideas. Having heard of cowpox 
among the milkers at a farm near Berkeley, he took off 
some of the fluid from a large vesicle on the hand of a 
dairymaid, Sarah Nelmes, and on the 14th May in- 
oculated it at two places on the arms of a boy, James 
Phipps, aged eight years. The experimental inoculation 
held, just as the accidental inoculation of milkers held, 
especially at cracks or scratches on their fingers. On 
the 2nd of July Jenner inoculated the boy with small- 
pox, by way of proving whether the previous cowpoxing 
Iiad made him insusceptible of the variolous infection. 



REJECTED BY THE ROYAL SOCIETY. 3/ 

In the course of the autumn or winter he put together 
a number of statements which he had picked up about 
cowpox in cows or milkers, and several cases of cow- 
poxed milkers known to himself who had not taken 
epidemic smallpox subsequently, or who had resisted 
the artificial inoculation of it. 

Out of these materials, along with the experiment on 
James Phipps, he constructed a paper, and sent it, 
perhaps accompanied by the drawing of the cowpox on 
the hand of the milker, Sarah Nelmes, to the Royal 
Society, either in the end of 1796 or early in 1797. It 
was handed about, perhaps in an informal way, and was 
shown by Sir Joseph Banks to Lord Somerville, president 
of the Board of Agriculture. The opinion formed of it, 
particularly by Everard Home, was unfavourable, so 
that after having been shown to the Council of the 
Society,! it was returned to Jenner. The subject was 
new to science, and the evidence for Jenner's contention 
must have seemed hardly strong enough to justify the 
referees in giving the paper a place in the Philosophical 
Transactions. Lord Somerville, however, stated that he 
had heard from a practitioner at Bland ford, in Dorset, 
that the protective power of cowpox against smallpox 
was talked of in that county also, which was, indeed, the 
scene of the earliest known experimental cowpoxing 
by Farmer Jesty, and probably the native soil of the 
legend. 

There is no exact record of the line taken in the 
original paper ; but we know that it contained only the 
one cowpox experiment on James Phipps, and that it 

* Jenner to Moore, about 1809, in Baron ii. 364. 



38 THE POX, THE SMALLPOX, AND THE COWPOX. 

contained neither the horse-grease cases nor the horse- 
grease experiment, which had no existence until March, 
1798. It is probable, therefore, that the famous horse- 
grease doctrine of the source of all genuine cowpox, if it 
occurred in the original paper at all, was no more than 
outlined therein. The rejection of his paper by the 
Royal Society gave Jenner the opportunity of altering 
it considerably, before he brought it out in 1798, just as 
the return of his cuckoo manuscript (at his own request, 
however) had enabled him at the last moment to intro- 
duce the startling novelties described in the foregoing 
chapter. As no historical scrutiny of the great Jennerian 
legend can be too minute, it will be proper to consider, 
before we go farther, what had been the doctrine of 
cowpox, and the evidence for the same, which Jenner 
originally offered to the Royal Society. 

Uncomplicated with horse-grease, the doctrine of cow- 
poxing was the simple country tale that milkers who 
had acquired the pox of the teats on their fingers were 
protected from smallpox. In dressing this up for the 
Royal Society, Jenner had, of course, to assume the airs 
of a man of science, and, above all, to bring in experi- 
ments. A century of English science had shown that 
any doctrine or project, no matter what its dialectical 
absurdity, was sure of an attentive hearing, and even a 
warm welcome, if there were a show of experimentation 
about it It was not until Jenner had got some experi- 
mental evidence that he proceeded to put the vulgar 
cowpox legend into the form of Royal Society science ; 
without a certain amount of experimental support, he 
would hardly have ventured to bring it forward at all, 
for the ordinary common-sense medical experience of 



EXPERIMENT AND EXPEKIENCE. 39 

his neiglibourhood was dead against the protective 
idea. 

The experimentation was of two degrees : firstly, to 
inoculate old cowpoxed milkers with smallpox in order 
to see whether they would take it ; and, secondly, to give 
the cowpox of purpose to a child, and then apply the 
variolous test. Why any one wanting to get at the truth 
should prefer experiment to casual experience in the 
case of old cowpoxed milkers, is beyond comprehension ; 
the real but unavowed and perhaps unconscious object 
of experimenting upon them was, in fact, to circumvent 
experience, and to find a " scientific " reason for a com- 
fortable illusion, Jenner accordingly kept silence about 
the cases of cowpoxed milkers subsequently smallpoxed, 
which he might easily have collected in considerable 
numbers from the experience of his own district. He 
confined his attention to such cowpoxed milkers as had 
jiol subsequently received smallpox either by accident 
or design ; and these cases he adduced as experimental 
proof of the protective power of cowpox. 

In two or three of them, the experimental test had 
been merely the "exposure" of the cowpoxed person to 
the contagion of smallpox — as if the majority of adults 
and elderly persons in those days had not been equally 
exposed with equal immunity. In a few others the 
experimental proof was discovered retrospectively in the 
failure to inoculate them with smallpcx when others 
were being inoculated ; but it was not attempted to 
prove that these failures in cowpoxed adults were more 
frequent than in adults not cowpoxed. Two or three 
more were variolated by Jenner himself with the par- 
ticular intention of testing their resibtance acquired 



40 THE POX, THE SMALLPOX, AND THE COWPOX. 



through cowpox. Quite elderly milkers were chosen, 
including worn-out paupers, in order to prove that the ■ 
lapse of time did not weaken the resistance — as if , 
advancing years did not also weaken the susceptibility 
to the smallpox virus. 

But it is when we come to the ethical credit of | 
Jenner's original proofs of protection by experimental 
test that we have most reason for amazement. If | 
his logic was bad, his candour was worse. "I ci 
ceived it," he wrote, "to be of the greatest importance i 
in conducting these experiments to attend to the state 
of the variolous matter previous to inserting it into 
the arms of those who had gone through the cowpox." 
The attention which he wanted paid to "the state of 
the variolous matter" was exemplified in his own deal- 
ings with case iii. John Philips, cowpoxed at nine, 
then aged sixty-two, was tested for protection by inocu- 
lating him with variolous matter " taken from the arm 
of a boy just before the commencement of the eruptive ' 
fever" I must leave the full significance of this artifice 
to be made clear in chapter vi., on "The Variolous 
Test"; but I can anticipate so far as to say that the 
method of inoculation which Jenner warned his readers 
to use in their tests, if they would avoid " much subse- 
quent mischief and confusion," was simply the extreme 
form of the bogus methods of Gatti and Daniel Sutton, 
whereby the effect of inoculation was reduced to the 
mere shadow or formality of smallpox. The matter 
for inoculation was not taken from a natural or acci- 
dental eruption of smallpox ; it was taken from the local 
pustule alone of an artificial inoculation, and it was 
taken from the very earliest period of the local pustule 



A BOGUS TEST. 4I 

at which any fluid could be got at all, or "just before 
the commencement of the eruptive fever." By that 
means, as a French variolator of the time reports, " the 
smallpox becomes at length weakened to the point of 
nullity, so that the last inoculations are without effect." ^ 
The deliberate choice of the merely serous fluid from the 
merely local pustule of a previous inoculation on the 
arm made the absence of anything like effective variola- 
tion a certainty. That was how Jenner himself circum- 
vented the damning truth of ordinary experience by the 
method of experiment, and that was how he earnestly 
desired that all others should try the variolous test after 
him. A mode of inoculation was coolly chosen, which 
was likely to produce the minimum of effect ; and when 
the minimum of eff'ect was produced, the previous cow- 
poxing of the individual got the credit of it. 

It is not surprising that the Royal Society should 
have found Jenner's experimental proof of protection 
both meagre in quantity and doubtful in quality. But 
the paper might still have been made a valuable one 
by giving in it a precise account of the cowpox itself, 
which was a curious and hitherto undescribed disease. 
The paper contained no such precise account. It can 
hardly have been so dominated by crude theorizings 
about horse-grease as the later form of it, the Inquiry 
of 1798; but the opportunity of giving a full, candid, 
and scientific account of cowpox was not embraced. It 
does not appear that Jenner had ever any intimate 
first-hand knowledge of cowpox in the cow, such as 



* Salmade, La Pratique de P Inoculation, Paris, An. vii. (1798) 



42 THE POX, THE SMALLPOX, AND THE COWPOX. 

Clayton, the Gloucester cow-doctor, had (see chap, iii.), 
or such as Ceely acquired by diligent observation in 
the Aylesbury district forty years later. He knew, 
however, that it was an ulcerous condition of the teats, 
which " the cow-leech usually kept in check by escharo- 
tics," that it was a local malady, and that it was catch- 
ing only through contact with the matter both to other 
cows and to the milkers. Of the milkers' sores he may 
well have had a more particular knowledge, for they 
were not so very uncommon, and much more easily 
studied. He knew them to be of the nature of painful, 
phagedenic ulcers, which varied in severity or inveteracy, 
sometimes taking a long time to heal ; they began in a 
big whitish or bluish-white bleb, almost the size of a six- 
penny piece, as his own picture of Sarah Nelmes* hand 
clearly showed ; the tumid white skin shrivelled after 
a week or two, and either broke to become an open 
sore, or formed a crust (as the sores on the cow*s teats 
were apt to do), beneath which a greyish foul ichor 
would continue to be produced for some time. It was 
not a nice disease, any way one might look at it ; and 
Jenner ought to have known why the dairy folk had 
instinctively called it a pox. 

Jenner*s contribution to the scientific knowledge of 
it in milkers consisted of little more than the good 
coloured plate of the infection on the hand of the 
dairymaid. He does not even say whether the vesicle 
in that case became the painful ulcer that it usually 
became ; he is content to let the reader go away with 
the impression, for the particular case which he illus- 
trates, that the disease was a vesicular " eruption.*' 
When Ceely came to deal with the subject in a scien- 



LIKENESS TO SMALLPOX IMPLIED. 43 

tific manner, he represented the successive stages of 
pimple, vesicle, and ulcer side by side ; and any one 
may see that the ulcers in Ceely's plates ^ have 
** specific " characters of the several types of indurated 
and inflammatory. No plate was given of the inocu- 
lated disease in the boy Phipps ; but the details in the 
text are rather more full than in the case of the dairy- 
maid from whom the infective matter was taken. I 
now give the sentence on which the emphasis was 
intended to fall : " The appearance of the incisions in 
their progress to a state of maturation were much 
the same as when produced in a similar manner by 
variolous matter." 

That statement really amounts to little ; it merely 
tells us of appearances presented by the incisions in 
their progress to a state of maturation ; but the lan- 
guage is the old terminology of smallpox inoculation, 
and the impression left upon the not very critical reader 
is that cowpox was a form of smallpox. It is possible 
that Jenner may have so believed, notwithstanding the 
total unlikeness of the ulcers on the cow's teats or 
milker's fingers to the contagious skiii-eruption of man ; 
it may never have occurred to him to ask himself why 
cowpox had been called a pox in colloquial speech 
long before his time. It is conceivable that his 
ambition to find a scientific basis for the legend of 
cowpox protecting from smallpox blinded him to 
obvious facts. But that can never justify him in 
coming before the Royal Society and the medical pro- 
fession in the way that I have now to speak of. 

^ Trans, Prov, Med, and Surg, Association^ 1840 and 1842. 



44 THE POX, THE SMALLPOX, AND THE COWPOX. 



The title of Jenner's cowpox paper is: "An Inquiry 
into the Causes and Effects of the Variolje Vaccina, a 
Disease discovered in some of the Western Counties, 
especially Gloucestershire, and known by the name of 
the Cowpox." An objection might be taken to "dis- 
covered," but let that pass. The leading line in this 
full and learned title is Variolse Vaccinse, which is the 
only name in the short title. Now Variola Vaccina is 
Latin for smallpox of the cow. An affection of cows 
and milkers, which had been known to country people 
for generations as the cowpox, is suddenly introduced 
to the learned, who had never heard of it before, under 

11 brand-new name. The new name is put in the fore- 
front of the title, it overshadows the old country name 
both by its prominence and by its semblance of scien- 
tific precision, and, for purposes of short reference, it 
becomes the sole name. This startling novelty is on 
the title-pages, and only on the title-pages. Jenner never 
says, in the preface or text, that the name is a new one, 
hitherto unheard of in veterinary or medical writings; 
be never says a single word to justify its invention ; he 
never once uses it in the preface or text at all. But 
there it stands in the title as the full, correct, and scien- 
tific name of the disease, to be copied in journals and 
repeated in a hundred ways when not another word of 
the essay would be copied or repeated, carrying with it, 
in short, all the power over the ideas that a descriptive 
or suggestive synonym for an unfamiliar thing does 
naturally carry with it.' 
: 



I 



' Jenner never publicly defended the innovation, but the follow- 
ing jottings were found among his posthumous papers, and primed 
by Baron (ii. 30) : — 



I 



FACTS SUPPRESSED. 45 

As one subterfuge entails many more, so Jenner's 
misleading title-page led him into the suppression of 
material facts and the suggestion of false issues through- 
out his text. Only one instance concerns us at the 
present stage, the great historical instance of his first 
vaccination upon James Phipps. The incisions on his 
arms, we are led to believe, went on at first very much 
as if he had been cut for the smallpox itself; on the 
ninth day he was perfectly well ; there was some erysi- 
pelatous redness, ** but the whole died away (leaving on 
the inoculated parts scabs and subsequent eschars) with- 
out giving me or my patient the least trouble." Very 
hearty and reassuring, no doubt ; but the modest 
parenthesis about subsequent eschars is the cloven hoof 
peeping out. The meaning of eschars following the 
first encrustation of the cowpox sores on the arm is 
made quite clear to us by the narratives of more candid 
and honourable men who have vaccinated with matter 
direct from the cow's teats or the milker's fingers. 

To take an instance from the very earliest vaccinations after 
Jenner's own, those described by Hughes, of Stroud : ^ William 
King, aged fifteen, was inoculated in December, 1798, with matter 
one remove from that taken by Jenner himself from a poxed cow 
at Stonehouse ; on the tenth day the lad had the efflorescence or 
areola just as James Phipps had ; on the eighteenth day " the 

" The origin of smallpox is the .same as that of cowpox ; and as 
the latter was probably coeval with the brute creation, the former 
was only a variety springing from it. On this ground I gave my 
first book the title of * An Inquiry into the Causes and Effects of 
the VariolcB Vaccines'^ — a circumstance which has since been re- 
garded by many as the happy foresight of a connexion which was 
destined by future evidence to become more warranted." 

* Med, and Phys. Journ, i. (1799), P- 318. 



46 THE POX, THE SMALLPOX, AND THE COWPOX. 

central scab put on the appearance of an eschar ; " on the twenty- 
ninth day the eschar came away, leaving an ulcer a quarter of an 
inch deep, which was treated with mercurial ointment and gradu- 
ally healed up. 

That is the meaning of the furtive parenthesis, " leav- 
ing on the inoculated parts scabs and subsequent 
eschars/' If we allow for the eschars coming into view 
after the superficial crusts had fallen, for the gradual 
exfoliation of the eschars (usually helped by poulticing), 
for the filling up of the ulcerous cavities by granulations, 
and for the covering over by new skin, we shall have 
to conclude that James Phipps, even if he were ** per- 
fectly well on the ninth day," had sore arms for several 
weeks. The two places on his arms could have been no 
more than healed on the 2nd of July, when he was 
tested with smallpox ; according to the usual practice, 
the smallpox matter would have been inserted on the 
arms near to the place of vaccination ; and, under the 
circumstances, it would not have been surprising if the 
local pustule had failed to come to maturity, even as- 
suming that Jenner had used a more certain means to 
inoculate the smallpox than the bogus method of Sutton 
which he advised his readers to use in their tests. We 
do not know that the local variolous pustule was actually 
kept back in the case of James Phipps ; Jenner does 
not say so ; he says merely that " the same appearances 
were observable on the arms as we commonly see when 
a patient has had variolous matter applied, after having 
either the cowpox or the smallpox." When he was 
tested a second time, " no sensible effect was produced 
on the constitution." "Poor Phipps," as Jenner called 
him, was often tested and never "took"; he was a poor, 



THE ROYAL SOCIETY NOT SATISFIED. 47 

ailing creature, suspected of phthisis, but perhaps only 
scrofulous ; he was not a fair subject for trying small- 
pox inoculation upon. 

All things considered, it was not to be wondered at 
that the referees of the Royal Society declined to re- 
commend Jenner's cowpox paper for publication in the 
Philosophical Transactions, There was not a very high 
standard of critical insight at the Society under the 
presidency of Maecenas Banks ;^ but there would have 
been at all events an appreciation of authenticated 
details, of plain matter of fact, of directness, and of all 
such qualities by which the good faith of a scientific 
worker would be guaranteed even if mistakes lay con- 
cealed in his observations and fallacies in his reasoning. 
Jenner had everything in his favour at the Royal 
Society. His previous communication had been received 
with favour and even indulgence ; he had been elected 
a fellow a few months after its publication ; Banks, the 
president, was his friend ; Everard Home (whom he 
blamed most of all for the rejection of the paper on 
cowpox) had been his fellow-boarder at John Hunter's 
five-and-twenty years before ; he had found a novel sub- 
ject in an undescribed disease of scientific interest and 
of practical importance to milk producers and milk con- 
sumers. The reasons that could have led to the paper 
being returned to him can only be guessed ; but we 
shall not go very wide of the mark if we guess them to 
have been a certain meagreness in the original observa- 



* See Whewell, History of the Inductive Sciences^ with reference 
to the reception of Thomas Young's undulatory theory of light 
(1802). 



48 THE POX, THE SMALLPOX, AND THE CO>yPOX. 

tions upon cowpox, a certain secretiveness in the 
manner of their setting forth, a suspicion of irrelevancy 
or one-sidedness in the cases of protected milkers, and 
a pervading sense of something improbable in expound- 
ing the properties of such a disease as cowpox under 
such a title as Smallpox of the Cow. 






:..:-\i '' '... ^. ;:.».-* . .. - 



;zo^7^ 



CHAPTER III. 

JENNER^S " INQUIRY." 

THE historian of the Cowpox Legend has always 
a double thread to unwind : on the one hand, the 
secret history of Jenner's project, as we can now follow 
it by the help of posthumous documents ; and, on the 
other hand, the history of it as it was presented to and 
received by the public and the medical profession at 
the time. If the profession and the public had been 
permitted to know then all that is known now (not 
reckoning the practital failure of cowpox to exterminate 
smallpox after ninety years* trial), they would probably 
have found out Jenner to be the vain, imaginative, 
loose-thinking person that he certainly was by nature, 
and they might have so acted as to prevent him from 
becoming the impostor and shuffler that the course of 
events made him. 

After the refusal of his paper on Cowpox by the 
Royal Society, Jenner resolved to publish it on his own 
account. We know from his biography that he had 
resolved to do so in the autumn of 1797 ; so that it was 
not the sudden accession of new matter in March, 1798, 
that induced him to offer to the public that which the 
Royal Society had refused, although the fresh evidence 
doubtless served to hasten the execution of his resolve. 

49 E 



so jenner's "inquiry." 

*. JT ejrthe/. didriTot takf hb^-cbuff- by the academical men 
of* adicH^d ^rH "tlte: cJiast^ey J^Hif^Avhich such rebuffs 
ought always to create in us. On the contrary he bore 
a grudge against Sir Joseph Banks and Sir Everard 
Home for years after. But he took the opportunity, 
all the same, of amending and fortifying the argument 
of his paper. 

The year 1797, in which he had his manuscript re- 
turned, saw the real adoption of the famous doctrine of 
horse-grease as the one and only source of genuine 
cowpox. It is true that cases i., ix., and x. in the 
casual lot of old cowpoxed milkers are introduced as 
proofs of the horse-grease origin of cowpox ; and these 
cases may have been in the original paper. If so, the 
evidence offered to the Royal Society on the origin of 
cowpox from the horse would have stood as follows : — 

Case I. — ^Joseph Merret remembered having been long ago, in 
1770, at a farm where several horses began to have sore heels, 
which he frequently attended to. The cows soon became affected 
with the cowpox, and soon after several sores appeared on his 
hands. Conclusion : Joseph Merret carried horse-grease to the 
cows. 

Case IX. — Not quite so long ago, in 1780, William Smith, in 
this parish, was on a farm where a horse had sore heels, and it 
fell to his lot to attend him. The cows on the farm developed 
cowpox, "and^r^w the cows it was communicated to Smith.'* In 
1791 Smith again caught cowpox sores on his fingers at another 
farm, there being in that case no record of grease among the 
horses. In 1794 he acquired cowpox ulcers a third time in milk- 
ing cows, the relevant circumstance of greased horses being again 
absent. 

Case X. — Sixteen years before, in 1782, Simon Nichol lived as 
a farm-servant with Mr. Bromedge. He had to apply dressings 
to the sore heels of a horse, and at the same time assisted in 
milking the cows. " Not until several weeks after he had begun 



THE HORSE-GREASE THEORY. 



' to dreis the horse" did oovvpoK occur arooiiythe *ovs. '-He 
quitted Mr. Broiiiedge'.j serviei; nviijtout an:^-sor,esiu^<i/t tii-m but, 
soon after goinf; to his next place, his hands became affected with 
cowpox sores. " Concealing the nature of the malady from his 
master, he was employed in milking, and the cowpox was com- 
municated to the cows." 



These aitless reasonings were hardiy up to the 
standard of Newton's Rules of Philosophizing, or of any 
other rules of evidence which the Royal Society was in 
the habit of applying to the matters that came before 
it. Even Jenner himself must have been conscious 
that the evidence for horse-grease, assuming that he had 
given it a place in the original paper, wanted strength- 
ening. Accordingly we find him, in the course of the 
year 1797, setting about new inquiries on horse-grease 
and its relation to cowpox. Biographer Baron's account 
of these researches is, that Jenner in 1797 "made many 
efforts to generate cowpox from the heel of the horse." 
The sole ground of this grandiose assertion is Jenner's 
own statement that he "sent a messenger to Bristol to 
procure virus [from the horse] in vain. I even procured 
a young horse, kept him constantly in the stable, and 
fed him with beans in order to make his heels swell ; 
but to no purpose." This beautiful experiment having 
failed, the research was laid aside until February, 1798, 
when three cases occurred in Jenner's parish of stable- 
men with sores on their hands, caught, it was supposed, 
from dressing the heels of a greased horse. At the 
same farm cowpox occurred on the cows' teats about 
the same time ; so that there was now an abundance 
of material within Jenner's reach. 

On the i6th of March he inoculated a child on the 



52 jenner's "inquiry." 1 

atm^^itif.n^ltCf: froiti a-hocafi-scre iji one of the stable- ^ 
mferf,'an(3"'onVfrc same daj'liie.Woailated another child | 
with matter from a cow's teat. From the latter child . 
he continued the succession of cowpox matter upon I 
children's arms through four removes, and on the 24th 
of April he left Berkeley for London with the manuscript 
and drawings of the Inquiry in his pocket. The pre- 
face of the Inquiry is dated (from London) on the 21st 
of June, and in a week or two after it was in the 
hands of the booksellers, a quarto of some seventy- 
pages, in the largest of type, and with the widest of 
margins, illustrated by four coloured plates, and costing 
seven shillings and sixpence. 

The name of Variolse Vaccin:E on the title-page, 
without any apology for it, or even a single repetition 
of it, in the text, was Jenner's master-stroke. Next to 
his title-page in effectiveness was his very adroit pre- 
face. Some few would read the book, more would , 
read the preface, and most would get their impressions 
from the title alone. The preface is in the form of a 
letter to Dr. Parry, of Bath. 

"Mv DEAR Friend, — 

" In the present age of scientific investigation, it is 
remarkable that a disease of so peculiar a nature as 
the Cow Pox, which has appeared in this and some of 
the neighbouring counties for such a series of years, 
should so long have escaped particular attention. 

" Finding the prevailing notions on the subject, both 
among men of our profession and others, ex'trcmely 
vague and indeterminate, and conceiving that facts 
might appear at once both curious and useful, I have 1 



SCIENTIFIC PRETENSION'S. S3 

instituted as strict an inquiry into the causes and effects 
of this singular malady as local circumstances would 
admit" 

As coming from a fellow of the Royal Society 
located in the very centre of the cowpox districts, 
nothinn; could be more in character than that preface. 
The hour was come, and the man. A peculiar country 
disease had been long known, but had hitherto escaped 
particular attention ; but the scientific spirit of the age 
had penetrated to it in the person of Edward Jenner, 
M.D., F.R.S. ; and the extremely vague and indeter- 
minate notions hitherto held about it by rustics and 
country practitioners were now to vanish before a strict 
inquiry, and to be replaced by scientific facts at once 
curious and useful. As a programme this was singularly 
in keeping with the fitness of things. It was exactly 
what we had a right to expect, what we all knew that 
it was the business of science to do. When a fellow of 
the Royal Society, adorning the vocation of a countrj' 
doctor, promised to substitute strict inquiry for the 
extremely vague and indeterminate notions prevailing 
on a curious subject among men of his own profession 
no less l^an among others, there was every reason to 
expect that he would be as good as his word ; it was 
just the .sort of thing that the Royal Society and its 
several fellows were specially constituted for and dedi- 
cated to. The modest and at the same time firm tone 
of this preface, from "My dear Friend" down to "as 
strict an inquiry as the circumstances would admit," 
could not fail to bespeak confidence in the author, the 
more so that he had already earned for himself the 



54 jenner's "inquiry." 

highest scientific aRix to his name by using well 
rustic opportunities. 

Ifvve are ever disposed to complain of the laxity of i 
criticism which allowed Jenner's nostrum to pass into 
currency as a good thing, let us remember what a couji 
de main he was able to execute. The fabric of things 
is based in a sense upon credit ; and the world was very 
willing to extend its credit to one whose pretensions as 
an innovator were justified equally by his scientific 
rank and by his unique opportunities. Nowadays we 
can bring historical scrutiny to bear upon these events ; 
and in the way of such scrutiny we may now proceed 
to inquire whether the pretensions of Jenner's preface 
were warranted by his text. 

The notions concerning cowpox prevalent among 
his medical colleagues were, he says, " extremely vague 
and indeterminate." Now these are just the terms in. 
which Jenner's medical neighbours in Gloucestershire 
were wont to characterize the popular fancy, that the 
cowpox of milkers protected them from smallpox. We 
have this important piece of evidence on the authority 
of Jenner himself, as reported by his biographer. Dr. 
Baron writes:' "Dr. Jenner has frequently told me 
that, at the meetings of this Society [the Convivio- 
Medical, which met at the Ship at Alveston in the 
southern division of the county, and was attended, 
among others, by Fewster, the chief authority on cow- 
pox], he was accustomed to bring forward the reported 
prophylactic virtues of cowpox, and earnestly to recom- 
mend his medical friends to prosecute the inquiry. All 



WHAT JENNER'S COLLEAGUES KNEW. 55 

his efforts were, however, ineffectual ; his brethren were 
acquainted with the rumour, but they looked upon it 
as one of those vague notions from which no accurate 
or valuable information could be gathered, especially 
as most of them had met with cases in which those 
who were supposed to have had cowpox had subse- 
quently been affected with smallpox." 

These were the very men whom Jenner, in his preface, 
included among those who held " extremely vague and 
indeterminate notions " on the subject of cowpox. But 
the vague notions were not theirs ; they were the mere 
idle talk and old wives' gossip of the country side, 
suggested by the jingling sound of "cowpox — smallpox," 
and suited to the general character of medical folk- 
lore, especially to the wide-spread belief in protection 
or cure by means of charms or amulets. Fewster and 
the rest knew that there was nothing in it ; and in course 
of time they came to regard Jenner as a bore, when he 
persisted in taking the protective virtues of cowpox 
seriously, against their own abundant experience to the 
contrary. Jenner, however, had one great advantage 
over them — he was a fellow of the Royal Society ; it 
was no less than his prerogative, as a man of science, 
to reduce the common notions about cowpox to the 
scientific scale. Only, he ought not to have led the 
world to believe that his professional neighbours shared 
these vague and indeterminate notions. They had good 
reason, as men of experience, for not sharing them ; and 
Jenner had good reason for knowing their invincible 
scepticism. So long, however, as he himself kept to 
his scientific task of instituting as strict an inquiry as 
local circumstances would admit, his rather unkind 




56 



JENNER's " INQUIRY." 



imputation of vague notions in the minds of otnei 
medical men might pas 

Besides the medical practitioners in the cowpox dis- 
tricts, there was another class of men, the cow-doctors 
and horse-doctors corresponding to the subsequently 
organized veterinary profession, who had a knowledge 
of these matters, empirical perhaps, but certainly not 
vague and indeterminate. Whatever the state of edu- 
cation formerly among the veterinarians, there had 
never been lacking among them men of sagacity and 
natural powers of observing. One such practitioner, 
Clayton, of Gloucester, who attended at most of the 
dairy farms within a radius of ten miles of the city, was 
induced to put his experience of cowpox on record for 
publication in the Contributions to Physical and Medi- 
cal Knowledge, issued by Dr. Beddoes, of Bristol, early 
in 1799. a volume which had the honour of publishing 
also the first researches of Humphry Davy. Clayton 
gave his evidence as follows^ : — 

That the chief diseases of the cow are the lough, swellings of 
the udder, and cowpox ; the two former are the most common, the 
latter being rarely seen except in spring and summer :— 

That cowpox begins with white specks upon the cow's teats, which, 
in process of time, ulcerate ; and, if not slopped, extend over the 
whole surface of the teats, giving the ■ 

That, if this disease is suffered to 1 
generates into ulcers, cxudi 
matter ; but this generally a 
of the disease, or from some 

That this disease may ar 
riating the teats ; but th; 



I 



cowpox 



a malignant and highly ci 
5 from neglect in the incipient stage 
use he cannot explain :— 
from any cause irritating or exeo- 
oflen chapped without the 
ihey generally swell ; 




WHAT THE COW-DOCTORS KNEW, 57 

but in the cowpox the teats seldom swell at all, but are gtadually 
destroyed by ulceration ; — 

That this disease first breaks out upon one cow, and is com- 
municated by ihe milker to the whole herd ; but, if one person 
was confined to strip the cow having this disease, it would go no 
farther :— 

That the cowpox is a local disease, and is invariably cured by 
local remedies :^ 

That he never knew this disease extend itself in the highest 
degree to the udder, unless mortification had ensued ; and that he 
can at all times cure the cowpox in eight or nine days ; — 

1^ That he is conversant with the diseases of the horse, and ex- 
tensively employed, particularly in curing the grease : — 
I That he cannot recollect ever to have had horses with the grease 
Itnd cows with the cowpox under care at the same farm : — 
That he is very certain he has frequently had cowa with the 
Itowpox, where no horses whatever have been kept ; — 
That the grease is most prevalent in the winter, at which time 
lie has never known the cowpox to occur. 
■ These depositions of Clayton, the veterinarian, were 
taken down by Cooke, a surgeon apothecary in good 
practice in Gloucester, who adds to Clayton's state- 
ment: "There is little variation from this account in 
the information I have obtained from some of the most 
respectable dairy-farmers in this neighbourhood. Those 
who have seen the cowpox among their domestics all 
agree that, if tliey have been soon afterwards inoculated 
for the smallpox, they have had the disease very 
slightly ; but, since the late general inoculation, are as 
fully satisfied that many have had the smallpox in a 
more decided manner who some years before had the 
cowpox very severely." He gave also the notorious 
case of a cowpoxed farmer who had died of the small- 
pox. 

More evidence of the same kind was soon forthcoming, 



JENNER'S "INQUIRY." 

to which I shall refer in the next chapter, dealing with 
the reception that the Inquiry met with from the pro- 
fession and the public. I have given here the experi- 
ence of the best employed veterinarian in Jcnner's own 
county merely to show what stores of information were 
at his service if he had cared to use them, Beddoes 
sent him a proof of the Gloucester evidence ; he sent 
also another paper from his forthcoming volume, by 
Thornton, a surgeon of Stroud, who had been inoculat- 
ing the cowpox independently of Jenner in 1798, and 
with rather startling results. Neither the veterinary 
experiences nor the medical, as we shall see later, were 
such as suited Jenner; and this is how he replied to 
Beddoes, on 26th February, 1799 : 

" I have neither the leisure nor inclination at the 
present moment to enter into an examination of their 
arguments, much less shall I attempt to refute the 
opinions [why "opinions"?] of either of these gentle- 
men. . . . The same equitable tribunal [the public], 
perhaps, will not fail to discriminate between the man 
who sedulously employs the greatest part of his time 
in making experiments for the complete investigation 
of a confessedly complex subject, and him who appears 
peremptorily to decide on the truth or falsehood of a 
theory, on the supposed authority of a few solitary in- 
stances, which after all may have been mistaken or 
misunderstood." 

Here we have the same lofty tone as in the preface 
of the Inquiry, coupled with a bold disparagement of 
evidence far more comprehensive on the veterinary side, 
and far more fully and accurately recorded on the medi- 
cal side, than his own. This reply to Beddoes is the 



J 



DISPARAGEMENT OF OTHERS. 



59 



beginning of tlie long course of bullying, and most effec- 
tive bullying, by means of which Jenner bore down 
all honest experience adverse to his own pretensions. 
Every candid reader, every man of the world, who has 
gone through this chapter so far, will have begun to see 
that Jenner is not the sort of person who can be taken 
at his own valuation. Let us then scrutinize this in- 
quiry, "as strict as the local circumstances will admit," 
these labours of " the man who sedulously employs the 
greatest part of his time in making experiments for the 
complete investigation of a confessedly complex sub- 
ject." 

The only real experiment in the paper on cowpox, 
as originally offered to the Royal Society, was the in- 
oculation of James Phipps ; the results of it, as we have 
seen, were recorded with a brevity which enabled jenner 
to suppress the true and suggest the false. It is absurd 
to claim the dozen old cases of cowpoxed milkers, who 
were subsequently inoculated with smallpox, as experi- 
ments ; there were many cowpoxed milkers, as Cooke's 
inquiries showed, who submitted to inoculation along 
with others, whenever a general inoculation was afoot ; 
and Jenner's cases were only a few, favourable to his 
contention, which he happened to have inoculated in 
he course of his own business or to have heard of. So 
'ar from " sedulously employing the greatest part of his 
ime in making experiments for the complete investiga- 
ion of a confessedly complex subject," he himself stands 
the man who "peremptorily decides on the truth or 
'alsehood of a theory, on the supposed authority of a 

.V solitary instances." 

As regards his great doctrine of horse-grease being 



I 



jenner's "inquiry." 



the only source of genuine cowpox, liis paper i 
original form did not contain a single experiment or 
even a single fact to show that horse-grease ever gave 
rise to the pox on the teats of cows. Sarah Nelmes, 
whose cowpox sore furnished the virua for the solitary 
James Phippa' experiment, is described simply as 
having caught cowpox from milking her master's cows, 
the disease having originated in a cow bought at a fair, 
and therefore spontaneously, on Jenner's own admission. 
Whatever experiments he made between the return of 
his paper from the Royal Society and the publication of 
the Inquiry were all done in the course of five or six 
weeks in March and April, 179S. It may be conceded, 
however, that it was the method of experiment which- 
Jenner used, in so far as he used any method at all; 
whereas his country neighbours merely took facts as 
they came, and reasoned upon them in the ordinary 
way. 

The ordinary experience of cow keepers and cow- 
doctors, as we have seen, was that cowpox arose here of 
there, by some concurrence of circumstances, in a par- 
ticular cow, and was transmitted to other cows by the 
matter on the hands of the milker. As Clayton, of 
Gloucester, said : " if one person was confined to strip the 
cow having the disease, it would go no farther." Cow- 
pox, in fact, arose "spontaneou.sly " in some one cow, 
on the top of some common afl'ection, such as chapped 
teats, or an eruption of pimples brought out by the 
spring season or by an over-distended state of the 
gland ; although chapped teats or pimples did not always 
end in cowpox. Neglect, as Clayton said, had a good 
deal to do with it ; and, of course, the ruthless necessity 



W SPONTANEOUS COWPOX IS SPURIOUS. 6t 

Bof relieving the turgid organ by "stripping" the teats 
Blended to aggravate any small beginning of soreness 
Aipon the latter. That was the rational or common- 
■sense view of how the pox of the teats arose in a 
I cow here and there, and it was abundantly confirmed by 
Ceely forty years after. The covvpox was " spontaneous," 
as the phrase ran ; but it became infective also, gene- 
rally going the round of every cow in the same shed, 
and very commonly affecting the milkers with painful 
sores on the -fingers, and with swollen and painful 
glands in the armpits, which caused them to go about 
having their shoulders raised in so characteristic a way 
_ that every one knew what was the matter. 
I Jenner, in a modest footnote to the first edition of the 
Inquiry, admitted that there was such a thing as spon- 
taneous cowpox of the cow's teats, "and instances have 
occurred, though very rarely, of the hands of the ser- 
vants employed in milking being affected with sores in 
consequence, and even of their feeling an indisposition 
from absorption." But why " very rarely " ? Until 
Jenner appeared upon the scene, this was the only cow- 
pox ; the past experience of the country related to that, 
and to that alone. If the milkers "felt an indisposition 
from absorption," the pox was the real thing, according 
to one of his own tests ; therefore these awkward cases 
had to be admitted, but made "very rare." The motive 
of this deliberate sophistry comes out in Jenner's second 
pamphlet; "Whether a disease generated in this way 
[spontaneously] has the power of affecting the constitu- 
tion in any /;■«(/;>??- manner, I cannot presume positively 
to determine. It has been conjectured [why "con- 
jectured" ?] to have been a cause of the true cow-pox. 



62 



jenner's "inquiry." 



though my inquiries have not led me to adopt this 
supposition in any one instance ; on the contrary, I 
have known the milkers affected by it, d7tt aht^ays found 
that an affection thus induced left tke system as susceptible 
of the smallpox as before." 

It is impossible to show more naivete in begging the 
question. The "genuine" cowpox of Jenner was, in 
short, whatever should not be followed by an attack of 
smallpox, whereas that cowpox was " spurious" which 
the smallpox contagion gave no heed to ; and that dis- 
tinction was called for in the first instance by way of 
confronting the testimony of Jenner's medical neigh- 
bours, that tliey had known many cowpoxed milkers 
(or, as Baron puts it, " milkers supposed to have had 
cowpox") who had fallen victims to smallpox in the 
usual way. 

The need having thus arisen to make out some cow- 
pox genuine and some spurious, it remained to take off 
the arbitrary edge of the distinction by facts or theories. 
The old spontaneous sort was on the whole spurious, so 
many milkers having received no protection from small- 
pox by its means ; the genuine would have to be some- 
thing special, and obviously it must not be spontaneous. 
To carry it to a source one remove off from the cow 
was enough ; and here was the grease of the horse's 
hocks as if ready for the occasion. That Jenner believed 
in his heart the grease itself to be of spontaneous origin, 
we know from his comical attempt to induce it in a 
young horse by keeping him in the stable and feeding 
him upon beans. 

The curious and possibly misleading thing was that a 
farrier's or stableman's sore on the finger, caught from a 



F A MISLEADING RESEMBLANCE. 63 

greased liorse, was almost the same as a milker's sore 
caught from a poxed cow. For an interesting illustra- 
tion of that fact Jenner was indebted to liis experienced 
neighbour, Fewster, surgeon, of Thornbury, whose nar- 
rative is printed in Jenner's second pamphlet. 

" William Morris, aged 32, servant to Mr. Cox, of Almonsbury, in 
this county, applied to me ihe 2iid of April, 1798. He told me 
thai, four days before, he found a slifTness and swelling in both his 
hands, which were so painful, it was with difficulty he continued 
his work ; that he had been seized with pain in his head, small 
of the back, and limbs, and with frequent chilly fits succeeded 
by fever. On examination 1 found him still affected with these 
symptoms, and that there was a great prostralitin of strength. 
Many parts of his hands on the inside were chapped, and on the 
middle joint of the thumb of the right hand there was a small 
phagedenic ulcer, about the size of a large pea, discharging an 
ichorous fluid. On the middle linger of the same hand there was 
another ulcer of a similar kind. These sores were of a circular 
form, and he described their first appearance as being somewhat 
like blisters arising from a burn. He complained of excessive 
pain, which extended up his arm into the axilla. These symptoms 
and appearances of the sores were so exactly like the Cow Pox, that 
I pronounced he had taken the distemper from milking cows. He 
assured me he had not milked a cow for more than half a year, 
and that his master's cows had nothing the matter with them. 1 
then asked him if his master had a greasy horse? which he 
answered in the affirmative ; and further said that he had con- 
stantly dressed him twice a day for the last three or four weeks or 
more, and remarked that the smell of his hands was much like 
that of the horse's heels. . . ." 

Jenner's account of the grease is condensed into a 
few vague and useless lines : " It is an inflammation 
and swelling of the heel, from which issues matter 
possessing properties of a very peculiar kind, which 
seems capable of generating a disease in the Human 
Body (after it has undergone the modification I shall 



64 JENNERS "INQUIRY. 

presently speak of), which bears so strong a resemblance 
to the Small Pox, that I think it highly probable it may 
be the source of that disease." 

It is one of the evils of making a man a fellow of the 
Royal Society, that people will be apt not to recognise 
any subsequent nonsense that he may write, in the 
narhe of science, for what it really is. The horse-grease 
has so strong a resemblance to smallpox, that he thinks 
it highly probable it may be the source of that disease ! 
But it is only after it has undergone a certain modifi- 
cation that horse-grease resembles the smallpox and 
may be the source thereof. Here, then, is a malady of 
a kind that may possibly be induced by feeding a horse 
with beans to make his heels swell ; next, a stableman, 
"having been appointed to apply dressings to the 
heels of a Horse affected with the grease, and not pay- 
ing due attention to cleanliness, incautiously bears his 
part in milking the Cows, with some particles of the 
infectious matter adhering to his fingers ; a disease is 
communicated to the cows, and from the cows to the 
dairy-maids, which spreads through the farm until most 
of the cattle and domestics feel its unpleasant conse- 
quences. Thus the disease makes its progress from the 
Horse (as I conceive) to the nipple of the Cow, and from 
the Cow to the Human Subject " — -in the form of the 
epidemic smallpox of history ? 

No one in 1798 could suppose that there was any- 
thing vague and indeterminate in this account of cow- 
pox, and its relation to smallpox, Jenner having stated 
in his preface that these were just the qualities which 
he was going to banish from his treatment of the 
question, by instituting as strict an inquiry as the local 



EXPERIMENT WITH HORSE-GREASE. 65 

Vircu instances would admit ; moreover, he had silenced 
the most experienced veterinarian in the county of 
Gloucester (who had never met with covvpox and horse- 
grease together at the same farm, but had often seen 
cowpox where no horses were kept) with a reminder 
that he had better not attempt peremptorily to decide 
the truth or falsehood of a theory on the supposed 
authority of a few solitary instances, so long as he, 
Jcnner, a fellow of the Royal Society, was sedulously 
employing the greatest part of his time in making 
experiments for the complete investigation of a con- 
fessedly complex subject. 

But the only experiment on horse-grease that he had 
made, besides that of the young horse kept in the 
stable and fed with beans to make his heels swell, was 
the experiment to inoculate a child with the virus of a 
stableman's horse-sore. Knowing what Jenner did of 
the nature of horse-sores on stablemen's and farriers" 
hands, it was a reckless, not to say an unjustifiable 
thing in him to seek to induce the same on a young 
child. Moreover, what was the experiment designed 
to prove more than the inoculations by accident had 
already taught him .' He knew from his quite recent 
cases of horse-sores on the hands of stablemen, in 
February, 1798, what the inoculated grease was like ; he 
knew also that two out of three horse-greased farmers 
or farriers (cases xiv. and xv. of the Inquiry) had 
received smallpox infection afterwards, the plain in- 
ference being that the one infection was nothing to the 
other. An experimental trial after such an experience 
could only mean that he was dissatisfied with the 
experience, that he meant to circumvent the plain 



66 



jenner's "inquiry." 



:hing of it if he could, and to tie knots i 
common-sense issues, by a resort to so-called scientific 
method. Aa it turned out, his experimental inoculation 
of the horse-grease virus upon a child resulted in rather 
more than he found it expedient to disclose. 

On the l6th of March, 1798, Jcnner took virus from 
a sore upon the hand of a stableman, Thomas Virgoe, 
who had been infected while washing the heels of a 
greased mare, and inoculated it upon the arm of John 
Baker, aged five years. The record of the experiment 
is sufficiently brief : "He became ill on the sixth day 
with symptoms similar to those excited by cowpox 
matter. On the eighth day he was free from indis- 
position." So far as the text is concerned, that is all. 
A coloured plate is given of the boy's arm, representing 
a stage of the infection probably later than the eighth 
day, although wc are left to guess the date ; the large, 
whitish vesicle has fallen in, there is evidently a sore of 
some depth beneath the brown sloughing cuticle, and 
there is an angry, brick-red zone of erysipelas for some 
distance around. If the child was free from indis- 
position on the eighth day, it was only because the full 
force of the filthy infection had still to be felt. A mere 
look at the collapsed vesicle in the picture will satisfy 
any practised eye that sloughing ulceration was 
imminent, and the brick-red colour of the skin around 
is equally ominous. 

It is beyond all mere guessing, however, that the | 
vesicle did become an ulcer ; we know that, not from | 
anything that Jenner himself ever disclosed, but from 
what his biographer. Baron, who seems to have been 
a simple-minded enthusiast, inadvertently published 



WANT OF SCIENTIFIC CANDOUR. 6/ 

long after. In explaining and justifying the horse- 
grease hypothesis, Baron printed from among Jenner*s 
papers an enumeration of six points wherein inoculated 
horse-grease resembled inoculated cowpox ; ^ one of 
the points was the " disposition of John Baker^s pustule 
to run into an ulcer." The same enumeration had 
already been given by Jenner in his second pamphlet 
(April, 1799); but in the six points, as Jenner had 
printed them from the copy, the reference to John 
Baker's "pustule" is merely to its "progress and general 
appearance," the original clause about the ulcer being 
conspicuously omitted. That authentic evidence, then, 
will carry us beyond the eighth day of the case, when 
the child was " free from indisposition." 

There is no doubt that Jenner intends the narrative 
of this child's inoculation with horse-sore virus to con- 
clude with the reassuring statement that, on the eighth 
day, he was free from indisposition. It is only in a 
footnote on a subsequent page, inserted to explain why 
John Baker was not tested with smallpox after being 
horse-greased, that we read : " the boy was rendered 
unfit for inoculation from having felt the effects of a 
contagious fever in a workhouse soon after the experi- 
ment was made." The child, it appears, was rendered 
unfit for inoculation by unhappily becoming a corpse ; 
he felt the effects of a contagious fever, soon after the 
experiment was made, to some purpose, for he died 
of it 

After a year's interval, Jenner wrote of John Baker's 
case without any euphemisms such as " felt the effects 

* Baron, i. 248. 



jenner's "inquiry." 



of a fever." Having occasion to mention the case" 
note in his next pamphlet, he says, with simple inadver- 
tence, that the boy "unfortunately died of a fever at 
a parish workhouse"; it is not even a "contagious 
fever." If the fever had been typhus, or scarlatina, or 
measles, why did he not remove all ambiguity by say- 
ing so? Reading between the lines, with the help of 
horse-grease pathology and Jenner's own plate, we may 
safely conclude that this child of five, lent for the 
experiment by poor parents under some cajolery or 
other, had an ulcerated or sloughing arm from the 
virulent matter inserted into it, that he had erysipelas 
(which is both a fever and contagious), that he was 
sent to the parish workhouse, that he died there, and 
that this village tragedy was all enacted within a period 
"soon after the experiment was made." Such is the 
one experiment with horse-grease which Jenner intro- 
duced into the Inquiry, and such is the candour of it. 

On the same day (i6th of March, 1798) that he 
inoculated horse-grease on one child, he inoculated 
matter from a poxed cow's teats on another child. He 
will have us believe that one of the three horse-greased 
stablemen, John Haynes, carried the infection to the 
cows. The evidence is of the most flimsy kind ; rio 
exact dates are given, nor any full statement of the cir- 
cumstances. We are merely told that Haynes was daily 
employed as one of the milkers at the farm, and that 
cowpox "began to show itself among the cows about 
ten days after he first assisted in washing the mare's 
heels." Of course there may have been a number of 
other things relevant to this outbreak of cowpox, but we 
are told nothing more; we are not even told anything 



COWPOX TRIED AGAIN. 69 

about the disease upon the fingers of Haynes, whether 
he caught it when he first " assisted '* in washing the 
mare's heels, or, as in every one of the cases (i., ix., and 
X.) of the Inqtiiry^ only after the cows had become 
affected. The concurrence of the two diseases at the 
particular farm probably meant that there was no more 
care and cleanliness in the stable than in the cowhouse. 
Jenner seems to have had a larger experience of these 
double events than any one else ; they reflect somewhat 
on the ignorance and slovenliness of Jenner's parish, but 
they do not establish the origin of cowpox from horse- 
grease. 

We come, then, to Jenner's actual experiments with 
virus from the cow*s teats, leaving the theory or reason- 
ing as it stands ; — 

" William Summers, a child of five years and a half old, was 
inoculated the same day with Baker, with matter taken from the 
nipples of one of the infected cows, at the farm alluded to in page 
35. He became indisposed on the sixth day, vomited once, and felt 
the usual slight symptoms till the eighth day, when he appeared 
perfectly well. The progress of the pustule, formed by the infection 
of the virus, was similar to that noticed in case xvii. [James Phipps], 
with this exception — its being free from the livid tint observed in 
that instance." 

t 

Here again the experimentee was perfectly well on 
the eighth day; but if the " progress of the pustule " was 
similar to that of James Phipps, the boy Summers can 
hardly have been perfectly well during the days follow- 
ing the eighth. James Phipps, as we have seen, had 
subsequent eschars, which meant deep ulcers, which 
meant slow healing and a good deal of disturbed health 
for several weeks. Ulceration of the arm has been 
the almost uniform experience with cowpox virus direct 



JO JENNER'S "INQUIRY." 

from the cow's sore teats or from the milker's sore hands, 
as we shall see in subsequent chapters.^ Jenner, who 
was something of an exquisite, spared his readers these 
unsavoury details whenever he could ; only he will persist 
in dropping hints about eschars and the like, when he 
might just as well have suppressed the disagreeable facts 
altogether. 

The child Summers ought to be even more famous 
than the child Phipps, because he is the first vaccinifer 
on record. On the 28th of March, being the thirteenth 
day of his infection, matter was taken from his arm and 
inoculated upon William Pead, aged eight years. Again 
the narrative touches lightly on some of the aspects of 
cowpox, while it emphasizes others : — 

" On the sixth day he complained of pain in the axilla, and on 
the seventh was affected with the common symptoms of a patient 
sickening with the smallpox from inoculation, which did not 
terminate till the third day after the seizure. So perfect was the 
similarity to the variolous fever, that I was induced to examine the 
skin, conceiving there might have been some eruptions, but none 
appeared. The efflorescent blush around the part punctured in 
the boy's arm was so truly characteristic of that which appears on 
variolous inoculation, that I have given a representation of it. The 
drawing was made when the pustule was beginning to die away, 
and the areola retiring from the centre." 

The " dying-away pustule " is still a big, whitish bleb 
with a fallen-in, brownish centre ; it is quite probable, 
from the look of it, that it became an ulcer, but of course 
Jenner dislikes mentioning things of that kind. We 
are told of the fever or constitutional disturbance, which 
was safe neutral ground whereon to make a comparison 

* See also my Natural History of Cowpox and Vaccinal Syphilis 
(London, 1887), chapters i. and v. 



A SERIES OF VACCINATIONS. 7 1 

with smallpox ; and about the efflorescent blush, which 
might also be common ground in almost any inoculated 
infection of the kind. But of those features wherein the 
infection was wholly unlike even the local pustule of 
inoculated smallpox, we are told nothing. 

From the arm of the boy Pead " several children and 
adults were inoculated '* on the 5th of April, or the ninth 
day. It is clear, from the text, that most of these did 
badly, although we have no details ; but from one of 
them, Hannah Excell, a child of seven, matter was taken 
on the 1 2th April, or the eighth day, and some of it 
inoculated upon four children, three pf whom did badly 
(no particulars), while the other, Mary James, whose 
vesicle ** scabbed quickly without any erysipelas," became 
the vaccinifer of J. Barge, a child of seven. The date 
of Barge's vaccination is not given (nor indeed any other 
particular information about the case) ; but it must have 
fallen between the 19th and 24th April. On the latter 
date Jenner left Berkeley for London, taking with him 
his MSS., his drawings, and a sample of vaccine lymph 
dried upon a quill, being part of that which he had 
taken from Hannah Excell (third in order from the cow) 
on the 1 2th of the same month. 

He remained in London until the i4th of July, getting 
the Inquiry printed, and otherwise looking after the 
interests of his strange project. The preface of the 
Inquiry bears the date of 21st June, so that we may 
assume that it was ready for delivery at the end of that 
month, or early in July. Within a week or so of its 
publication, Mr. Cline, surgeon to St. Thomas's Hospital, 
used the dried vaccine matter, which Jenner had brought 
to town, for the inoculation of a boy with hip-joint 



72 



JENNERS "INQUIRV." 



disease, having the ulterior purpose of turning the cow- 
pox sore over the hip into an issue. 

These are the facts, and this is how the biographer i 
Baron morahzes upon them : " It is a strange circum- 
stance that the author of that practice, a man known in 
the highest circles of medical science as worthy of all 
credit and as an accurate and enlightened observer, 
should have been unable, notwithstanding the proofs 
which his 'Inquiry' contained of the safety and im- 
portance of vaccination, to prevail on one individual to 
submit to the operation during his stay in London." It 
was, indeed, very natural that Cline and all Jenner's old 
set should wait until they had seen the proofs which the 
Inquiry did contain. They knew that the business had 
been discredited by the Royal Society the year before, 
notwithstanding the strong interest that Jenner had 
with Banks and others ; and they would have been told 
by Jenner, when he came to town to have his essay 
printed on his own account, that it now contained im- 
portant additions, which might lead his old friends to 
take a more favourable view of it after they had it in 

I print with the three new coloured plates. Now. when 
Cline wrote to Jenner on the 2nd August, to tell him of 
the result of the vaccination in London, he carries the 
narrative of it to the nth day of the vesicle, to its 
subsequent ulceration, to the testing inoculation with 
smallpox, and to the effects of the latter for three days 
longer; so that the first trial of the vaccine in London 
must have taken place not later than the middle of July, 
or within a week or so of the publication of the Inquiry. 
It was on the 14th of July that Jenner left London. 
We have now brought the narrative of events down 



THE GREAT QUESTION. J$ 

■to the date of publication, and have anticipated one 
small fact in the reception of Jenner's project by the 
medical profession. But, before we enter on the full 
history of its reception, there still remains to consider 
the evidence which he offered in the Inquiry, that cow- 
pox, whether caught accidentally or given experimentally, 
did, as a matter of fact, anticipate and ward off the 
attack of smallpox. It was upon that evidence, and 
the subsequent corroboration or refutation of it, that 
the vaccination controversy mainly turned. The name 
of Variola Vaccinie was accepted as proof enough that 
cowpox 'ii}as a sort of smallpox of the cow, the doctrine 
of the origin from horse-grease being passed over with 
indifference by practical men. The questions that really 
interested people were whether inoculation with the 
variola: vaccina, whatever that disease might be, was as 
good a protection from smallpox as inoculation with 
variola itself; whether it was unattended by a general 
eruption ; whether it was a milder and safer disease than 
variola proper; and whether it was free from the great 
and growing; objection to the latter of being a source of 
aerial contagion. On two of these questions Jenncr was 
pretty safe to get a verdict ; on the question of protect- 
ing from smallpox he wanted all the ingenuity of his 
very imaginative and unscrupulous mind to carry him 
through. 

Jenner led off, at page 6 of the Inquiry, with a bold 
statement, which his medical neighbours knew very 
well to be untrue: "What renders the Cow Pox so 
extremely singular is, that the person who has been 
thus affected is for ever after secure from the infection 
of the Small Pox ; neither exposure to the variolous 



74 



JENNERS "inquiry." 



I 



effluvia, nor the insertion of the matter into the skin 
producing this distemper. In support of so extra- 
ordinary a fact, I shall lay before my Reader a great 
number of instances." But first the reader is treated to 
tlie innocent-lool(ing footnote about genuine cowpox 
and spurious, the full significance and historical import- 
ance of which plea I shall deal with in chapter vii. 

Of the " great number of instances " of the variolous 
test, I have already examined those that were in the 
original evidence prior to March, I7QS. Jcnner's oppor- 
tunities in that and the following month were really 
considerable ; and, in so far as his variolous test was a 
valid test at all, it was much more to the point to try it 
upon young vaccinated children than upon a number of 
old cowpoxed milkers. We are loftily told, however, 
that it was superfluous, after all that had been said, to 
try the variolous test upon each of the children whom 
he had succeeded in infecting with cowpox : "After the 
many fruitless attempts to give the Small Pox to those 
who had had the Cow Pox, it did not appear necessary, 
nor was it convenient to me, to inoculate the whole 
of those who had been the subjects of these late trials." 

It was not convenient to Jenner, because he rushed 
off to London as soon as he had m'ade these few ex- 
periments on children, and without waiting to ask the 
great question, whether they were, as a matter of fact, 
insusceptible of smallpox inoculation, or what propor- 
tion of them were insusceptible. He asserts, however, 
that the boy Summers, the first of his series, was tested 
allpox and that " the system did not feel the 
effects of it in the smallest degree " ; but he does not 
say when this was done, nor by whom, nor does he give 



teiSting the vaccinated. 75 

any other details. He tells us, further, that two other 
children, Pead and Barge, were inoculated with small- 
pox by his assistant (after Jenner had gone on his 
London visit), who wrote as follows : " On the second 
day the incisions were inflamed, and there was a pale 
inflammatory stain around them. On the third day 
these appearances were still increasing and their arms 
Itched considerably. On the fourth day the inflammation 
was evidently subsiding, and on the sixth it was scarcely ' 
perceptible. No symptom of indisposition followed." 
This is not very precise and determinate ; but, even if 
we admit that the variolous matter failed of its usual 
effects upon children, we must bear in mind, not only 
that Jenner's method for the variolous test was the bogus 
method of Sutton, but also that the attempt was made at 
a time when the cowpox sores were quite recent, being 
either in a state of scabbing, or filled by eschars, or in 
open ulceration, and that any such active process on 
the skin, together with the clogging of the absorbent 
glands by the inflammatory action of cowpox virus 
itself, would be a sufficient hindrance to the full action 
of smallpox virus inserted near the same spot, or a 
cause of irregularities, at least, in its evolution and 
extent. 

We may now sum up the contents of the famous 
Inqtiiry into the Causes and Effects of the Variolce 
.Vaccince, which Jenner published to the world in the 
end of June, 1798. The programme of it was one thing, 
and the execution another. Extremely vague and 
indeterminate notions were to give place to the results 
of " an inquiry as strict as local circumstances would 
admit"; so, at least, the world was modestly told in the 



76 



jenner's "inquiry. 



preface. In the text, the unblushing invention of the 
misleading name of Variola Vaccina is never once 
reverted to ; the novelty, which none knew to be a 
novelty, is on the title-page and in the short title of 
the fly-leaf, but elsewhere it is passed over in discreet 
silence. The proofs that there existed both a genuine 
cowpox and a spurious, and that the former came from 
horse-grease while the latter was spontaneous, were both 
[ disingenuous in motive and puerile in effect. The proof 

of the main thesis, the protection from smallpox, was 
disgracefully scamped, even assuming that experiments 
were valid for proof The average experience of 
Gloucestershire milkers was ignored, Jenner being well 
aware that there were quite as many instances telling 
against protection as there were in favour of that popu- 
lar fancy ; only such cases as supported the notion were 
adduced, and these were set forth in such loose and 
meagre fashion as to be worthless according to any 
strict standard of evidence. Of all the children vacci- 
nated by Jenner, only one was subjected by himself to 
the variolous test, the result being stated in evasive or 
ambiguous language. He rushed off to London to 
publish his Inquiry, without waiting to see whether his 

I vaccinal ions of March and April, 1798, would stand the 
test, such as it was : only two, or perhaps three, of them 
were subsequently smallpoxed by his assistant. The 
test used and recommended was the bogus method 
of Sutton. Lastly, the similarity of cowpox to small- 
pox is craftily implied, not in regard to the vesicle 
and pustule respectively, but in regard to the constitu- 
tional disturbance and the efflorescence ; while the 
ulcerous course of the cowpox infection beyond its 



I 



CHARACTER OF THE "INQUIRY." ^^ 

vesicular stage, which would have put all affinity to 
smallpox out of the question and would have inevitably 
suggested the pox proper, was systematically suppressed. 
The same suppression was practised in the case of the 
child whom Jenner inoculated with virus from a horse- 
sore on a stableman's hand. 

It has to be kept in mind that Jenner's contempo- 
raries had not the means which we now have of detect- 
ing all this laxity and dishonesty in the form and 
matter of the Inquiry, In considering what reception 
they gave to the book and to the project, we must 
endeavour to put ourselves in their place. 



CHAPTER IV. 

THE RECEPTION OF THE "INQUIRY." 

" "O EFORE the publication of Dr. Jenner's treatise," 
-L/ writes Denman, a leading physician of the time, 
** the cowpox was unknown, even by name, to the gene- 
rality of physicians in the kingdom." ^ When they 
did come to hear of the disease, it was under the name 
of Variolae Vaccinae (smallpox of the cow), which Jenner 
had thought fit to give to it for reasons best known to 
himself. The name was accepted in good faith by the 
profession in all countries. The first French writers 
uniformly spoke of the new disease as petite virole des 
vaches ; the Germans at once adopted the synonyms 
Kuhblattern and Schutzblattem (** cow-smallpox " and 
" protective smallpox " ) ; and in Italy it was called 
vajulo vaccina ( " vaccinal smallpox " ). These terms 
were gradually superseded by the new word vaccine^ 
introduced at Geneva in 1799, which simply meant 
something pertaining to a cow, and carried no sug- 
gestion of disease in general, or of a pox-disease in 
particular. In colloquial English speech, cowpox 
continued in use for some time, and was then changed 
into cow pock. A reason for the change was given by 

* Med, and Phys, Journ,^ iii. (1800), p. 292. 

78 



"SMALLPOX OF THE COW" ACCErTED. 



79 



^Lwatcl 



& London surgeon, in the preface to an account of a 
notorious series of vaccinal ulcers at Clapham : ^ he 
says that he prefers cow pod, " as I conceive the word 
'pox' to be inapplicable, being the exclusive appellation 
of syphilitic affections." Not exclusive ; for usage in 
the western counties had given the name of pox to the 
loathsome affection of the cow's teats for generations 
past. The same unwarrantable liberty had been taken 
with the old English name by a German writer shortly 
before, on the ground that pock was a "milder and 
more convenient" name than pox.' In the United 
States, the liberty first taken with cowpox was to make 
it kine pox, as being "more delicate";* an^d, shortly 
after, kine pox became kine pock, which was doubtless 
more delicate still. 

If it should be said that these changes in an old 
name were not Jenner's doing, that he was not respon- 
sible for them, and that the leading title of the Inquiry, 
Variol.'E Vaccina, was not put there with any such 
deliberate purpose as I have asserted, those who so 
contend are invited to follow closely what was said by 
critics of the Inquiry, and what Jenner said, or caused 
to be said, in reply. Having found that the name on 
his title-page was adopted without suspicion, Jenner 
used it ostentatiously in the text of his second essay, 
although it is not used at all in the text of the first. He 
took some pains to secure its currency, and jealously 
■watched any reference to his innovation in the naming 



Pears, Land. Med. Rev., Jan., iBoi, p. 276, 
Neues Hanniivrisches Magaz., j8oo, p. 58. 
Watcrhouae, History of the Variola Vacdrta, elc. Boston, U. S., 



F'So THE RECEPTION OF THE "INQUIRY." 

of the disease. The earliest public friend of Jenner's 
project was Dr. George Pearson, F.R.S., physician to 
St. George's Hospital, a scholar, and an honourable if 
not a very clear-headed man. His Inquiry concerning tlu 
Histoty of iJte Cowpox'^ followed Jenner's in less than 
six months, and endorsed it. Pearson, however, was 
getting dangerously "warm" on more than one side of 
the mystification ; in particular his " Remarks upon the 
use of the term Variolse Vaccinae" were such as Jenner 
could not but read with alarm. Pearson's objection to 
the Latin name was of the mildly grammatical kind ; 
variola vaccinae, or smallpox of the cow, he opined, was 
a catachresis of speech, as if one were to speak of the 
plumage of a bear ; for it was not ascertained that the 
cow, or the bovine species, was subject to variolous 
disease at all. 

In his private correspondence Jenner wrote with 
some asperity about Pearson's exceedingly mild ob- 
jection to the name; and for public purposes he put 
forward his clerical neighbour, the Rev. T. D. Fosbroke, 
to overbear all such inconvenient remarks by a pro- 
digious display of philological and other learning. The 
clerical scholar wrote as follows in reply to Pearson, 
signing himself "T. D. Fosbroke, Vacco-variolist":^ 
" Every schoolboy knows that the meaning of variola 
is ' freckle ' or 'pimple,' and therefore that its modern 
and forced application to smallpox by no means de- 
stroys its original latitude of signification, and indeed 
real and only one ; and, of course, that it may be there- 
fore allowably so used. The Latins knew nothing about 

' London, 1798 (November). ' Jj^nd. Med. Sev., ii. 48a. 



i 



THE NEW NAME DEFENDED. 



Sr 



Smallpox ; how, therefore, could they appropriate the 
term to the disease in question ? " 

This rubbish was allowed to pass in the medical 
journal which was specially set apart for the work of 
criticism ; no one replied, or was permitted to reply, 
that variola, in its technical sense, ever since the middle 
ages had meant smallpox, and nothing but smallpox, 
and that cowpox blebs or crusts or sores or ulcerations 
were neither pimples nor freckles, A " vacco-variolist " 
also came forward about the same time in the columns 
of the Gentleman's Magasine;^ and a second lime iu the 
Medical Review? to contradict a London physician [Dr. 
Hooper), who had pointed out that milkers' cowpox 
sores were larger than the pustules of smallpox and 
otherwise unlike them, Jenner's advocate taking care to 
parade the terra " vacco-variolism " and to denounce the 
" malignancy " of objectors. 

It must seem strange to any one who reads Pearson's 
Inquiry now that it should not have sufficed at the time 
to show up the artifice of jcnner in re-naming cowpox 
"variola; vaccinae," or smallpox of the cow. Pearson 
made out very clearly, by the evidence which he col- 
lected, that the milkers' cowpox took the form of " pain- 
ful phagedenic sores," often lasting for weeks or 
months, which pointed to cowpox being a pox in the 
classical sense of the word. But he was too much cap- 
tivated by the idea of a substitute for variolation to 
read the true lesson of these facts. In August of the 
year following (1799) he had progressed so far in his 
easy-going assent to Jenner's teaching that he practi- 



82 



THE RECEPTION OF THE "INQUIRY." 



cally withdrew his objection to the name variola; 
cinK, which " I formerly endeavoured to show to be 
unjust and tending to mislead by giving erroneous 
notions." Pearson's final view seems to have been that 
cowpox and smallpox were "varieties of the same 
species"; but he never quite lost his early impression 
of their unlikeness. When the Ciapham cases of vac- 
cinal ulcers were making a stir in iSoo, he wrote ' that 
cowpox might indeed have something loathsome in its 
nature, but then it was " useful " ; it was one of those 
things 

"Which, like the toad, ugly and 
Wears yet a precious jewel in his head. 

Another London physician of repute, who got danger^ 
oiisly " warm " on the side of the new name and old 
nature of cowpox, was Dr. John Sims, a man of liberal 
tastes, who edited the Botanical Magazine for many 
years. Sims, in the innocence of his heart, thought 
that any information on the nature of cowpox would 
be welcomed. Accordingly he gave an account, in the 
very first number of the new London medical journal* 
(13th February, 1799). of the case of Mr. Jacobs, a 
prominent solicitor of Bristol, who had begun life in the 
humble position of a milker on his father's farm^ and 
had twice caught cowpox on his hands. Mr. Jacobs 
was perhaps the only one of the large number of cow- 
poxed milkers who could now make himself heard in 
the learned world on a matter of vulgar experience, 
which had assumed a sudden and wholly unlooked-for 
importance. " What this gentleman remarks," wrote 



I 



' Med. and Fhys. Jou 



., v. 37. 



* Ibid., i. p. I 



LIGHT FROM OTHER SOURCES. 83 

Sims, " of the loathsomeness of the disease, although a 
circumstance entirely overlooked in Dr. Jenner s ac- 
count, appears to be in itself a formidable objection to 
its introduction," not to mention the fact that Jacobs 
had twice taken smallpox afterwards. When Jenner 
read this, he wrote to a friend,^ calling Sims a " snarling 
fellow," and accusing him of " harsh and unjustifiable 
language." Private remonstrances were made to Sims, 
and he wrote again on the 20th April, that Jenner*s 
doctrine would appear to have been based upon " suit- 
able inquiries." A paragraph in the same number 
announces that Sims had acknowledged the Bristol case 
to be " spurious." In a yearns time Sims had progressed 
so far as to let his name appear near the top of the list 
of metropolitan physicians and surgeons who recom- 
mended cowpoxing to the public.^ 

The veterinary criticism, also, was highly inconvenient. 
That of Clayton, the Gloucester veterinary surgeon, has 
been given at length in the foregoing chapter ; two 
other testimonies of the same kind have now to be 
noticed. A well-known entertaining writer on veter- 
inary and rural subjects was John Lawrence, of Bury 
St. Edmunds, the author of a Philosophical and 
Practical Treatise on Horses and on the Moral Duties of 
Man towards tJte Brute Creation, and of other works. 
Lawrence promptly came forward to tell what he knew 
of cowpox in the eastern counties. " When the public 
ardour for the present topic," he wrote,^ " shall have 



Letter to Gardner, 7th March, 1799, in Baron, i. 321. 

July, 1800. 

Med. and Phys, Journ.y i. 114. 



84 



THE RECEPTION OF THE "INQUIRY." 



become a little cool and satisfied, I hope it will 
turned by enlightened men towards another perhaps oi 
nearly as great consequence, namely the prevention of 
the original malady in the animals themselves. Those 
who have witnessed, or only reflected upon the excessive 
filth and nastiness which must unavoidably mix with 
the milk in an infected dairy of cows, will surely join me 
in that sentiment." Lawrence was hopelessly before his 
time ; it was not likely that any one would listen to a 
person so absurdly Quixotic as to propose that cowpox, 
the source of Jenner's "guardian fluid," should actually 
be eradicated from among the diseases of the brutes. 
It was not until 1886-88 that we began to find out that 
"the filth and nastiness which must unavoidably mix 
with the milk in an infected dairy of cows " was a not 
uncommon cause of scarlet fever in those who used the 
milk, 

Another criticism of cowpox, from the cows' side of 
the question, was published soon after in an anonymous 
pamphlet' The author begins with some cautions to 
milkers not to handle the teats of cows too roughly, and 
then proceeds to inquire a little farther into the nature 
and extent of "this most horrible coptagion," These 
filthy ulcers, he points out, never arise except on the 
teats of a cow in milk ; there is no such disease of the 
bull, the ox, the maiden heifer, or the caif ; the disease 
was, in fact, incidental to the "stripping" of the teats 
by the hands of milkers. This bold rationalist objected 
altogether to inoculating disease in order to ward off 



I 



A CoHsciotts View of Circumstances and Proceedings t 
ing Vaccine Inoculation. London, i8oa 



■sped- 



OBJECTORS SILENCED. 



S5 



disease ; smallpox was subject to the same laws as the 
plague and the sweating sickness, which had had their 
day in England. The author of the Conscious View 
was severely handled by the medical critics. One 
journal gave him half a dozen contemptuous lines :^ 
" It is impossible for a candid mind to read this illiberal 
and, we may say, scurrilous pamphlet without feeling 
the most lively indignation." The other and more 
critical London organ gave a full summary of the essay, 
and concluded that it was written with too much 
acrimony and prejudice to have any influence on the 
practice, of cowpoxing, which was by that tinie in full 
swing.^ It does not appear who this anonymous writer 
was. His line is much the same as that taken by 
Lawrence, except that the latter was not whollj' opposed 
to the old variolous inoculation. 

The realities of cowpox and the utter unlikeness of 
it to smallpox were also dwelt upon by Moseley and 
others ; but as these opponents were destined to carry 
on a long warfare against the Jennerian project, I shall 
put off what I have to say of them until chapter xiii. 
on Dissent. 

The most formidable of Jenner'."! antagonists, judged 
by scientific or professional standing, was Dr. Ingen- 
housz, of Vienna, who happened to be residing in 
England when the Inquiry was published. 

Dr. John Ingen-housz, born at Breda in 1730, came 
to England in his youth and learned the art of inoculat- 

' Med. and Pkys. Joura., iv. 567. 

' London Medical Review, v. I have had to depend on the 
extracts from the pamphlet given by this Review, as the original 
is not to be found in libraries. 



86 



THE RECEPTION OF THE "INQUIRY." 



ing smallpox under Dimsdale. On the recommendation 
of Sir John Pringle, he was summoned in 176S to the 
court of Vienna by the Empress Maria Theresa, who 
had shortly before lost two of her children by the small- 
pox. After an obstinate struggle with his countryman, 
De Haiin, who was then all-powerful in the Vienna 
medical school, he succeeded in introducing inoculation 
into Austria and devoted a great part of his energies 
to it in after years. He excelled, at the same time, as 
a botanist, chemist, and physicist, and his name will be 
found honourably mentioned in the history of vegetable 
physiology and of electricity. His MisccZ/anea Physico- 
medica was well known both in German and Latin 
editions. 

In the autumn of 1798, being then in his seventieth 
year, he came on a visit to the Marquis of Lansdowne 
at Bowood. Jenner's Inquiry, which was just out, came 
naturally under the notice of so leading an authority on 
smallpox inoculation ; and he took advantage of his 
residence in Wiltshire to make inquiries about the 
"extraordinary doctrine" of protection by cowpox, as 
he knew that the cowpox was well known in that 
county. He first applied to Mr. Alsop, surgeon, of 
Calne, and was taken by him to a farmer of the neigh- 
bourhood named Stiles, who had seen the cowpox go 
through the cows in his father's time thirty years before, 
and had himself caught the infection in a very severe 
form ; when his cowpox sores were all healed, he had 
been inoculated with smallpox by Mr. Alsop ; the dis- 
ease was produced, many pustules came out, and he 
gave the smallpox to his father, who died of it. This 
v/as the information elicited by Ingen-housz on the very 



J 



DR. INCEN-HOUSZ. 



^7 



lirst attempt. He heard of several other facts of a 
similar kind, which tended to overthrow Jcnner's idea 
of protection. He advises Jenner to think it over "be- 
fore you finally decide in favour of a doctrine which 
may do great mischief should it prove erroneous." He 
prefers to approach Jenner privately rather than to 
draw him into a public controversy, "always disagree- 
able to a man so liberal-minded and well-intentioned as 
your treatise indicates you to be." 

Ingen-housz himself gave Jenner the cue for his reply. 
The famous inoculator of Vienna had noticed in passing 
the digression in the Inquiry about smallpox virus 
losing its properties, owing to some subtle imaginary 
putrefactive change, and producing a disease which was 
" certainly not smallpox," although it iiad all the look 
of it: it was not smallpox, because those who had been 
thus inoculated caught the smallpox naturally after- 
wards. No sensible and honourable man could endorse 
stuff of that kind, however much he might wish to 
excuse the failures of his own art. Spurious smallpox 
was afterwards disclaimed by Pearson, Woodville, and 
other inoculators who knew their business. It was a 
point which Ingen-housz could not let pass, and he tells 
jenner that if he will inquire more particularly, he will 
find that he is in error in setting up a spurious variety 
of smallpox ; there was no such thing known. Whether 
from mere momentary irritation or from deliberate 
design, Jenner answered Ingen-housz by extending the 
accusation of spuriousness to those very cases of cowpox 
which the Viennese doctor had heard of in Wilts. 
There was an offensive stench from the cows' udders, 
therefore the putrefactive process had been going on ; 



THE RECEPTION OF THE "INQUIRY. 



therefore the cowpox was spurious, and no wonder 
Farmer Stiles had taken smallpox after it.^ Hitherto 
spurious cowpox, in Jenncr's estimation, had been such 
varieties of it as did not come from horse-grease ; the 
necessity of replying to Ingcn-housz showed him how 
to extend the domain of the spurious, which he did still 

arther in his next essay. As Ingen-hous;; had the 
temerity to object to jenner's spurious smallpox, that 
worthy, whom no one would have accepted as an 
authority upon smallpox, replied not only by re-affirm- 

ng his statement, but by throwing spurious cowpox 
also at his adversary's head. The spuriousness in both 
cases had no other ground than the failure to ward off 
smallpox. Jenner did not allege that there was any- 
thing in the look of the one disease or of the other 
by which its "spurious" character might be known. 
Jenner's spuriousness, in the language of metaphysics, 
was a subjective, not an objective quality, 

A man of the world, as Ingen-housz was, must have 
very quickly seen that there was no use controverting 
the arguments of such a person as this, who was palp- 
ably cither a fool or a knave. He told an emissary of 
Jenner's, a surgeon, Paytherus, who called upon him in 
London on the 13th December, 1798, that "nothing 
would have kept him from answering Dr. Jenner's 
letters but the desire of satisfying his mind on the 
subject." He also "spoke very handsomely" of jenner, 



' One of the cases published by Abemethy for the Rev. R. Holt, 
of Finmere, was of a servant so dangerously ill wilh cowpox ulcera- 
tions that medical help was necessary for more than three weeks, 
the effluvia being so offensive as to penetrate every room in the 
boose. — Med. Phys. Jonm., ii. 401. 



THE OPINION OF BEDDOES. 89 

and sent him the advice to be in no hurry to publish a 
second time on the cowpox. He took no farther part 
in the controversy, and died during his next visit to 
Bowood in September of the year following (1799). 

The impression made by Jenner's book upon leading 
medical men throughout the country was a somewhat 
mixed one. Beddoes, of Bristol, told one of his col- 
leagues, who was a friend of Jenner*s, that he thought 
the Inquiry would do its author much credit ; ^ but in 
writing about the same time to Hufeland, of Berlin, he 
spoke disparagingly of it. 

The letter is worth quoting as an instance of the kind 
of criticism current just before Woodville came to the 
rescue : ^ — 

"You know Dr. Jenner's experiments with the cow- 
pox. His idea of the origin of the virus appears to be 
quite unproved, and the facts which I have collected are 
not favourable to his opinion that the cowpox gives 
complete immunity from the natural infection of small- 
pox. Moreover the cowpox matter produces foul 
ulcers, and in that respect is a worse disease than the 
mildly inoculated smallpox. With all this suppuration, 
the system remains on the whole unaffected ; accord- 
ingly nothing is gained thereby for the smallpox. They 
are occupied at present with experiments upon it at the 
Smallpox Hospital in London." 

Percival, of Manchester, congratulated Jenner on his 
publication, and went on to say :^ "But a larger induc- 

^ Hicks to Jenner, 3rd October, 1798, in Baron, i. 
2 Beddoes to Hufeland, 25th February, 1799, in Hufeland^s 
Journal^ vii. (1799), pt iii. p. 168. 

* Letter to Jenner, 20th November, 1798, in Baron, i. 



go 



THE RECEPTION OF THF. " INQUIRY. ' 



tion is yet necessary to evince that the virus of the 
■variola vaccina [he had clearly no suspicion of the 
name] renders the person who has been affected with it 
secure during the whole of life from the infection of 
smallpox." 

Francis Knight, a court surgeon in fashionable 
London practice, who was connected with Gloucester- 
shire, wrote, on the loth September, 1798, that the 
plates were correct, and that he "knew the facts to be 
well supported : at least it was a general opinion among 
the dairymen that those who had received the cowpox 
were not susceptible of the variolous disease. . . . 
It is sufficient for me to have proof that a lighter disease 
may be uniformly substituted for a greater one." And, 
to show his confidence in the discovery, he asks for a 
supply of lymph, adding: "I know some people of 
fashion who are well disposed to le^ me make tlie 
experiment on some of their children." 

It never for a moment occurred to Knight to suppose 
that Jenner was not then practising his new method, or 
that he had not as much matter for inoculation as he 
cared to use. An intimate friend of Jenner's, Dr. Hicks, 
of Bristol, was equally in the dark. Writing on the 3rd 
October (three months after the Inquiry was published), 
■ he says ; "I do not see that you need hesitate to accept 
of the invitation given you to inoculate with the cowpox, 
convinced as you arc that it will secure the person so 
inoculated from ever being infected with the smallpox." 
Jenner was "hesitating" for reasons that have now to 
be made clear. 

When he came to London in April to publish the 
Inquiry, he left his series of vaccinated cases in the 



i 



JENNER HAS NO LYMPH, 9I 

hands of his nephew and assistant, who would seem not 
to have carried the succession farther. Jenner took a 
sample of cowpox matter with him, and gave it to 
Ciine, who produced an ulcer with it in his first case, 
and failed altogether at the next remove. Cline then 
wrote to Jenner for a fresh supply of cowpox, never 
dreaming that there was any lack of it. He sent a 
handsome testimony of his own and Dr. Lister's belief 
in the new protective, along; with the account of his trial 
of it. When jenner afterwards used that letter, he 
struck out Cline's words, "The ulcer was not large 
enough to contain a pea, therefore I have not converted 
it into an issue as I intended," and inserted in their 
place the words, " There were no eruptions." ^ 

When Jenner went back to Gloucestershire in July, 
he heard of the prevalence of cowpox at a farm near 
Berkeley, and inoculated four or five of the farm ser- 
vants with matter from a cow's teat. These inoculations, 
which were in adults, all failed ; but, within a month, 
the same servants acquired cowpox accidentally from 
milking the infected cows. The accidental sores on 
their hands were, of course, a perfectly available source 
of matter, but jenner does not say that he resorted to 
it. In September, Dr, Pearson was urging him to begin 
the practice in earnest, and Jenner excused his want of 
cowpox matter by blaming Cline for failing to continue 
the old April stock in London, 

In the end of September cowpox appeared in a dairy 



' Cline's original letter was published by Baron {i. 152J, who 
does not seem to have known that Jenner had already used it — 
and tampered with it. 



92 THE RECEPTION OF THE " INQUIRV. ■ 

at the village of Stonehouse, on the Stroud road, not 
far from Eastington, where his friend Mr, Hicks had a 
factory. Hicks knew all the circumstances of the pub- 
lication of the Inquiry, and was ready to have his own 
two children inoculated in the new way. It would seem 
that no word of the cowpox at Stonehouse had reached 
hini until after it had been prevalent several weeks ; for 
it was not until 26th November that Jenner procured 
some of the matter, and next day inoculated with it the 
two Hicks children. The result is indicated vaguely in 1 
a letter to Woodville ; an inflammation in the arms, the | 
constitution unaffected, the local effects lasting more 
than a week, a small scab left behind. On the 2nd of 
December, a portion of the same lymph which had 
been dried upon a quil! was inserted into the arm of 
Susan Phipps, a child of seven. On the twelfth day the 
areola was out, and there were a numbgr of very minute 
confluent pustules round the big cowpox vesicle. "So 
exact was the resemblance of the arm at this stage to 
the general appearance of the inoculated smallpox," 
that Drake, a surgeon from Stroud, who had never seen 
the cowpox before, declared he could not perceive any 
difference between it and sniallpo.x. However, Drake 
took some matter from the child's arm and inoculated 
some cases of his own, with a result, as 'we shall see, 
that must have opened his eyes to the difference be- 
tween cowpox and smallpox. 

The utter unlikeness of cowpox to smallpox, and its 
singular generic resemblance to the great pox, became 
obvious in Jenner's own case in a few days ; the vesicle 
dried to a crust, the crust was cast off, and disclosed an 
ulcer, which continued to spread until it reached a size 



A CANDID UBSERVER. 93 

y as large as a shilling" — not very like s"ia//pox, 
one would suppose. Willi matter which had been 
taken from Susan Phipps' arm on the twelfth day, 
Jenner inoculated Mary Hearn, aged twelve. She had 
the areola on the fourteenth day, and an ulcerous state 
of the arm for some time after, which had to be treated 
with mercurial ointment. These facts are given by 
Jenner himself, although he prefers to call the ulcer a 
"pustule." 

It so happened that Thornton, of Stroud, got matter 
from the same Sconehouse farm on the ist of December 
independently of Jenner ; and both he and Hughes, of 
Stroud, who reported Drake's cases done with matter 
from the arm of Jenner's case on the 13th December, 
have left full narratives of their experience. These are 
in striking contrast to Jenner's ordinary equivocal and 
secretive manner in reporting his results. If vaccination 
at the outset had been left in the hands of men as 
candid as Thornton and Hughes, the public and the pro- 
fession would have declined to adopt it ; the immediate 
results were too uniformly alarming for the vaccinated 
children, and tiie subsequent test too adverse to the 
theory of protection from smallpox. 

Thornton's experience is historically important as 
being the first independent evidence that the Inquiry 
elicited. On the ist of December, 1798, he found a 
milker at the Stonehouse farm, with sores upon his 
hands ; one of these was still in the unbroken form of a 
pock, being " the only one that was not degenerated 
into a sordid and painful ulcer." The vesicles were seen 
first on the fingers five days before, having been pre- 
ceded by pain in the axilla, headache, cold shiverings, 



94 



THE RECEPTION OF THE "INQUIRY." 



fever and weakness. The same evening, on which he 
took the cowpox matter from the milker, Thornton went 
to Stafford's Mill and inoculated Mr. Stanton and four of 
his children, from ten years of age to ten months. On 
the third day the arms of the four children were affected 
with a kind of erj'sipelatous efflorescence above the 
point of insertion. About a fortnight after, the punctures 
began to be covered with a thick crust, from which 
some ichor was discharged for several days. The in- 
flammation subsided and the scabs fell off about the 
twentieth day. "From the long-continued local excite- 
ment," Mr. Thornton began to hope that the virus might 
imperceptibly have crept into the habit and proved 
a security against the variolous infection ; but it was not 
so, for when they were tried to see whether the cowpox 
had made them insusceptible, all the children "received 
the infection and passed through the stages in the usual 
slight manner"; the father, whose vaccination had 
failed altogether, was the only one of the five who J 
resisted the smallpox. 1 

This damning experience of cowpoxing, from a source 
used by Jenner himself and authenticated with full 
particulars, ought to have raised a suspicion that there 
was something wrong. It was communicated to Jenner 
by Beddoes, in whose Contributions to Physical and 
Medical Knowledge it was about to appear ; and Jenner 
replied to it, and to the equally damning veterinary 
experience of Clayton, of Gloucester, which was sent to 
him at the same time, by a bouncing declaration of his 
own superior credit as a man of science,^ 



INDEPENDENT INQUIRY AT STROUD. 95 

There remained, however, the other experience at 
Stroud, with cowpox matter taken by Jenner himself 
from the child vaccinated from the Stonehouse cows, 
and given by him to Drake on the 13th December. 
Drake sent the results of the five vaccinations and sub- 
sequent smallpox tests to Jenner shortly after ; but the 
facts were suppressed, and nothing would ever have 
been heard of them but for the following circumstances : 
The subjects offered for vaccination were the three young 
children of the Rev. Mr. Colborne, of Stroud, a lad in his 
employment, and another lad employed by Mr. Drake. 
Mr. and Mrs. Colborne requested another Stroud doctor, 
Hughes, who was a connexion of the family, to witness 
the operations by Drake and to follow the results. 
Hughes wrote out a tolerably full account of the five 
cases, from notes that he had taken, and sent it, under 
the date of 9th May, 1799, to Jenner, who forwarded 
it to the Medical and Physical Journal^ with the ex- 
planation that it had arrived too late for him to include 
in his second pamphlet. But he had already been told 
the main facts by Drake ; and in the second pamphlet 
he had deliberately omitted all reference to them, merely 

stating that "Mr. D , a neighbouring surgeon," had 

taken some matter from the arm of the child on 13th 
December. The trial, however, had made some noise 
in Stroud, Gloucester, and Bristol, and it would have 
been too risky for Jenner to have suppressed the second 
and fuller relation of facts by Hughes, as he had already 
done the more summary statement of failure by Drake. 
We now come to the cases as narrated by Hughes, 

In three of them, a lad aged seventeen and two of the Colborne 
children (one four years, the other fifteen months), the cowpox 



THE RECEPTION OF THE "INQUIRY." 



vesicles came to early maturity and were scabbed under the usual 
time. The lad was inoculated with smallpox on the 20ih Decem- 
ber, being the eighth day from his vaccination, and the two children 
on the 2lst, being again the eighth day. They all developed 
smallpox, both the local pustule and the general eruption with 
fever. The remaining two cases — a lad aged fifteen and the third 
Colbome child aged two years and a half — were also variolated on 
the 31 St December, or the eighth day of their vaccination; but 
these two developed the local pustules only. The reason why 
they did not have the consecutive fever and general eruption of 
smallpox will perhaps appear from the peculiar history of their 
cow pox sores. 

In the lad, W. King, the areola appeared on the tenth day and 
continued spreading until the fifteenih. On the eighteenth day 
the scab, which now occupied the centre of the vesicle, put on 
the appearance of an eschar, with much induration of the tissues 
around ; on the twenty-ninth day the eschar separated, and left a 
sore one-quarter of an inch deep, which, under treatment with 
mercurial ointment, filled up and skinned over in due course. He 
had meanwhile been tried a second time with smallpox, on the ist 
of January, but resisted it entirely, his cowpox sore being on that 
day and for a week longer in its eschar stage and his lymphatics 
doubtless clogged. The case of the child E. Colbome was some- 
what similar. On the tenth day her cowpox vesicle was the size 
of a sixpenny- piece, being mostly a scab with a narrow ring round 
the margin containing matter. On the fifteenth day the crust was 
thrown olf, and left a. small superficial eschar, which increased 
in depth in the next few days ; much inflammation followed in the 
skin around, and " two small suppurations " broke out a little above 
the original vaccine puncture, each of which reached the size of a 
shilling, one of them communicating with the original sore. On 
the 4th of February, being the fifty-second day from vaccination, 
the sores were all healed and the induration gone. Meanwhile 

I this child had also been tried a second time with smallpox on the 
1st of January, entirely without efFecL 
w 
: 



I 



It was a not incorrect summarj' of this experiment 
which had reached Jenner : " Two of them had alarming 
ulcerations on their arms, and these two, whose arms 



A CHECK TO THE PROJECT. 97 

were so dreadfully affected, did not take the smallpox, 
while the other three received it." 

At the end of 1798, or six months after the Inquiry 
was published, the case for cowpoxing as a substitute 
for inoculation with smallpox stood as follows : Nearly 
all the children's arms had ulcerated, some of them to an 
alarming extent, just as the milkers' hands nearly always 
ulcerated. Jenner neglected the variolous test in some 
of his cases, and got a rather equivocal result in others. 
The variolous test, when applied by Drake and Hughes 
in one set of cases, and by Thornton in another, gave a 
result which was as far as possible from bearing out 
Jenner's confident assurances. In some medical circles 
these adverse facts were as well known then as they 
are now to us in the retrospect ; and it is the strongest 
possible evidence of the good-will, nay, the welcome, 
extended to Jenner and his innovation, that the fatal 
objections were not pressed. 

Ulceration was so clearly written in the December 
experiments, both m Jenner's own hands and in the 
hands of Thornton and Drake at Stroud, that the artifice 
of the title-page, the foisted name Variolae Vaccinae, • 
looked as if it were going to be found out. It was 
probably thought imprudent to continue a stock of 
matter from the ulcerating Stonehouse source, or per- 
haps the attempt to continue it failed, as all Jenner's 
attempts to raise a stock had failed. At all events, 
neither Jenner himself nor the two surgeons at Stroud 
had any matter to go on with ; and the great cowpox 
project might have come to an end there and then if it 
had rested with Jenner to give practical effect to it 
At this point in the history of the substitution of cowpox 

H 



THE RECEPTION OF THE " INQUIRY. 



for smallpox inoculation, the end of 179S, thi 
changes from Gloucestershire to London. Jenner had 
made at least two attempts, subsequent to the publication 
of the Inquiry, to raise a stock of cowpox matter on the 
human arm, and had failed ; so that he was unable to 
supply those who applied to him. The most urgent of 
his correspondents was Dr. George Pearson, who had 
entered into the question far more methodically, but not 
less confidingly, than Jenner him.self. The results of 
his numerous inquiries by correspondence all over the. 
country, and of his own investigation among the London 
dairies, were published in November, 1798. 

In consequence of Pearson's bustling zeal, the dairy- 
men in London were induced to report any cases of the 
po.K among their cows ; and on Sunday, the 20th of 
January, 1/99, the news was brought to Woodville that 
the disease was among the cows at a dairy in Gray's Inn 
Lane. On Monday, Woodville repaired thither along 
with a veterinary student, who belonged to Jenner's 
parish and professed to know about cowpox. In a day 
or two the milkmaids had the blebs on their lingers, 
exactly as Jenner had figured in his first plate. The 
original sceptics and rejectors of Jenner's innovation, 
Sir Joseph Banks, Lord Somerville and others, were 
fetched to the cowhouse, and Jenner's book was pro- 
duced. Scepticism gave way to belief; for there, sure 
enough, was the identical large bluish-white vesicle on a 
milkmaid's hand which Jenner had pictured — indeed, " a 
more beautiful specimen of the disease than that which 
you have represented in the first plate." Having satisfied 
themselves that there was such a malady as cowpox, 
and that Jenner's picture of it in milkers was true to 



I 

I 

I 



WOODVILLE TO THE RESCUE. 99 

nature, they concluded that there was a. primd-facie case 
for giving it an independent trial. No body of English- 
men would have acted otherwise; whatever the irration- 
ality or dialectical absurdity of the project, they would 
put it to an experimental test. 

Matter was at once taken to the Inoculation Hospital, 
and a number of the applicants at that institution had 
it inserted into their arms, instead of the smallpox 
matter which they had come to receive. The succession 
of inoculations was kept up from arm to arm, and 
vaccination was established on the grand scale. From 
that perennial source Jenner himself was supplied with 
matter on the 15th February, and thenceforward circu- 
lated it as the " true Jennerian lymph. "^ It was just at 
this juncture that Jenner got the proof sheets from 
Beddoes of the damaging experiences of the Gloucester 
veterinarian and of the Stroud doctor; and it is no 
wonder that he replied (26th February) ; " I have 
neither the leisure nor inclination at the present moment 
to enter into an examination of their arguments." Cow- 
poxing was now a going concern, and all the theoretical 
objections in the world could not bring it to a stop. 

Woodville had come to the rescue with his solvitiir 
afnbulando. Nothing is more striking than the effect 
that this practical solution of the question had upon 
objectors ; within a few months they either withdrew 
and apologised for their scepticism, or they kept silent. 
In the month of June, 1799, within three months of the 
first diffusion of lymph and within a year of Jenner's 
first publication, the editor of the Medical and Physical 



lOO THE RECEPTION OF THE "INQUIRY." 

Journal wrote : " There is not, perhaps, in the annals 
of medicine, to be found an example of an experiment 
or inquiry where the life and health of such numbers 
already born, and of all to be born, were implicated, that 
has been taken up more generally, received more 
candidly, or conducted more prudently than this con- 
cerning cowpox." 

But Woodville did not merely supply a stock of 
lymph for all and sundry, learned and simple, to try 
their hand with ; he succeeded, by a mixture of luck and 
skill, in presenting cowpox to the profession in the sub- 
dued form which it has ever since retained in average 
practice, a form which surprised Jenner when he saw it, 
and was indeed very unlike the original ulcerous disease. 
The latter achievement, along with the actual supply of 
cowpox matter for all who wanted to try it, gave the 
new substitute for smallpox an irresistible vogue. Om7te 
tulit punctum may be said of Woodville : he provided 
vaccine lymph, while Jenner was still talking about it ; 
and he made the lymph comparatively innocuous, while 
Jenner was still floundering in the difficulties of erysipelas 
and phagedenic ulceration. We have now to see how 
cowpox came to acquire the rather mild type which it 
had when the profession and the public first made trial 
of it and accepted it. 



CHAPTER V. 

COWPOX MADE MILD AND ACCEPTABLE. 

DR. WILLIAM WOODVILLE, who started cow- 
poxing on the great scale and supplied all the 
world with vaccine lymph, was one of the most practised 
inoculators of his time. He had been a favourite pupil 
of Cullen at Edinburgh, and had come to London after 
trying country practice for a few years. In 1791 he 
was elected physician to the Smallpox and Inoculation 
Hospitals. He was a botanist of no small repute, having 
published ^ Medical Botany m three quarto volumes in 
1790 (subsequently edited by Sir W. J. Hooker), and 
laid out two acres of ground around the Smallpox 
Hospital (then at King's Cross) as a botanical garden, 
which he maintained at his own expense. 

In 1796 he published the first volume of a History 
of the Inoculation of the Small-pox in Great Britain^ in 
which he has the following remarks (p. 7) on cowpox : 
" It has been conjectured that the Small Pox might have 
been derived from some disease of brute animals ; and 
if it be true that the mange, affecting dogs, can com- 
municate a species of itch to man ; or, that a person, 
having received a certain disorder from handling the 
teats of cows, is thereby rendered insensible to variolous 
infection ever afterwards, as some have asserted, then 

zox 



102 COWrOX MADE MILD AND ACCEPTABLE. 

indeed the conjecture is not improbable." This was 
either taken from the paragraph in almost identical 
terms in Adams on Morbid Poisons, published the 
year before, or was derived from the same source ; 
namely, Jenner's private correspondence with Cline. 
Pearson speaks of Jenner's Inquiry as having been long 
expected ; the rumour of its main contention, that cow- 
pox protected from smallpo.x, had reached Adams, 
Beddoes, Woodville and others two or three years before 
the essay appeared. The proposed substitute for 
variolous protective inoculation would thus have caused 
a flutter among all the specialist inoculators, determining 
some of them perhaps towards opposition, and others of 
them towards giving the new plan a trial whenever it 
was ripe. 

Among the latterwas Woodville. He was approached 
by Jenner in London in the summer of 179S, when he 
came up to print the Inquiry, and gave the advice that 
horse-grease should be struck out from the text alto- 
gether.^ On the 17th of June, 1798, four days before 
Jenner wrote the preface to his Inquiry^ Woodville was 
present at the Smallpox Hospital while his friend 
Pearson tried the variolous test upon three formerly 
cowpoxed milkers from Willan's farm adjoining the New 
Road, Marylebone.^ It will thus appear that Woodville, 
along with Pearson, had become interested in the new 
protective inoculation, owing to private communications 
with Jenner in London, before the Inquiry was through 
the press. The variolous test on the three old cowpoxed 



^ H. Fraser, Med. and Phys. Jon 
' Pearson's Inquiry, pp. 14, 15. 



1805, p. 10. 



J 



PEARSON AND WOODVILLE. 103 

milkers was confirmatory, so far as it went, of Jenner's 
position ; none of them received tlie infection, while two 
men from the same farm, not previously cowpoxed, 
received it in the usual way. Pearson and Woodvillc 
were, accordingly, eager to begin cowpoxing on the 
great scale, and the former made several applications to 
Jenner for a supply of lymph in the course of the 
ensuing autumn. 

Jenner had no lymph to give to Pearson in September 
or November; nor did he succeed in cultivating a stock, 
supposing that he tried to do so, from the two cases of 
phagedenic cowpox ulcers in children after inoculation 
from the Stoneliouse cows in December. The only 
other persons who had fried the new practice up to that 
time were Cline, in July, with matter from Jenner ; Thorn- 
ton, of Stroud, on December ist, with matter taken by 
himself from a Stonehouse milker ; and Drake, of Stroud, 
witii matter from Jenner, on the 13th and 14th Decem- 
ber. From none of these inoculations with cowpox was 
a stock of matter raised ; they had all turned to ulcer- 
ation, like Jenner's own cases ; and at the opening of 
the year 1799 the project of cowpoxing, which had been 
recommended to the world by Jenner six months 
before and is commonly supposed to date in practice 
from that recommendation, was represented by some 
half-dozen children at Stroud and Eastington slowly 
recovering from cowpox ulcers on their arms. 

It is at this juncture that Woodville comes on the 
scene. On Sunday, the 20th of January, word was 
brought to him at his house in Ely Place that the cow- 
pox had appeared among the cows at a dairy in Gray's 
Inn Lane. On visiting the cowhouse next day (Jan. 31st) 



I 



104 COWPOX MADE MILD AND ACCEPTABLE. 

he found three or four cows affected witli "pus 
sores on their teats and udder." A veterinary student 
then in London from Jenncr's country, named Tanner, 
whom he had sent for, took matter from one of the 
cows " which appeared to be most severely affected with 
the pustular complaint"; and with that matter Wood- 
ville the same day inoculated seven persons at the 
Inoculation Hospital, " by a single puncture in the arm 
of each, or rather by scratching the skin with the point 
of the lancet till the instrument became tinged with 
blood." 

The aifection existed in only three or four of the 
cows when Woodville inoculated from it, but eventually 
it spread through the whole herd of some two hundred 
animals, those cows which were not in milk escaping. 
The infection was accordingly fresh, or recently started, 
or in the making, when Woodville first heard of it and 
obtained a supply of its virus. Calling again at the 
cowhouse two days after, on Wednesday, the 33rd 
January, he found two or three of the milkers with the 
beginning of cowpox on their hands. For only one of 
these are there details given, namely, Sarah Rice, who 
had four cowpox vesicles on her fingers, wrist, and 
forearm ; this milkmaid became an object of scientific 
curiosity, and on Thursday, the 24th, being the fifth 
day since she had noticed the whitish blebs on her hand 
or arm, her cowpox was inspected at the cowhouse by 
Lord Somerville, Sir Joseph Banks, Sir William Wat- 
son, Dr. Wilian, Dr. Pearson and several others, and 
compared with the plate in Jenner's Inquiry. 

Two of Sarah Rices four vesicles were a third of an 
inch or more in diameter on that day, and already 



I 
I 



J 



COWPOX WITHOUT ULCERATION. 10$ 

acquiring the bluish-white tint ; she had then some 
uneasiness in the armpit, and a degree of headache 
subsequently ; but none of the vesicles were painful, 
and they all gradually went o^ without producing ulcera- 
tion. She had been infected when the diseased process 
on the teats had hardly gone beyond the cow which 
first started it, and had presumably not yet acquired that 
type of specificity which a longer duration and succes- 
sive reproductions would give to it ; she had caught the 
disease, in fact, mildly, and it never came to painful open 
ulcers with her at all, but healed under the crusts or 
scabs. 

From one or more of the vesicles on her hand or arm 
Woodville had inoculated two men on the 23rd of 
January, being the fourth day since the vesicles had 
been noticed, and six other subjects at the hospital on 
the 24th, or the fifth day. He thus got matter for 
inoculation at what we must call an early stage of the 
cowpox vesicle. It is even more important to remark 
that the vesicles on the milker, whence the matter for 
vaccination was taken, were not destined to become 
painful open sores at all, having been caught from the 
first cow, or the first two or three cows, in a series that 
extended by successive transmissions of the infection 
until it reached to nearly two hundred animals, and 
must have lasted weeks or months. 

These circumstances had necessarily some significance 
for Woodville's success, as compared with the failure of 
Jenner and of Thornton with the Stonehouse cowpox 
in the month of December preceding. The failure to 
raise the much-demanded stock of lymph from that 
source was owing, so far as we know, to the ulcerous 



I06 COWPOX MADE MILD AND ACCEPTABLE. 

type of disease transmitted in the first remove from the 
cow direct, or from the milker ; and with that alarming 
type we may connect the fact that the cowpox had been 
passing from cow to cow at the Stonehouse farm in 
successive transmissions since Michaelmas, or for more 
than two months. The severity of type, which would 
have been thus cultivated by neglect or inveteracy, was 
shown to exist in fact, in the case of the man-milker 
from whom Thornton, of Stroud, took matter for his five 
inoculations at Stafford's Mill; the man's sores were 
supposed to be of the same age (fifth day) as in the 
case of Woodville's milkmaid ; and yet there was only 
one of them " which had not degenerated into a sordid 
I and painful ulcer" at even that early date, whereas 
( Sarah Rice's cowpox never became ulcerous at all. 

The pedigree of the world's vaccine, which is the 
pedigree of Woodville's stock, was thus derived from an 
exceptionally mild type of cowpox in the cow and in a 
milker, or from a stage of the particular outbreak at 
which the worst features of the infection had not had 
time to develop through neglect and aggravation. 
Woodville succeeded in passing cowpox matter for 
inoculation into common currency, after Jenner had 
several times failed in attempts to do the same ; and we 
have to associate with his success not only a certain 
superior skill as an inoculator, but also a large element 
of luck. 

We have now to see how his experiments at the 
Inoculation Hospital came out ; and how his practical 
success was achieved. It will appear that Woodville at 
the outset had as little of a reasoned and steady per- 
ception of the advantages of early cowpox as had Jenner 



CAUSES OF WOODVILLES SUCCESS. IO7 

himself. It was his good fortune to get early intelli- 
gence of an outbreak, and he made use of the matter for 
inoculation as soon as he knew of it. Thus blindly led 
by fortune, he overcame initial obstacles that had baffled 
Jenner, and were to give trouble to most of those who 
started new stocks of lymph in later years. Luck alone 
enabled him to lead off with a type of cowpox vesicle 
which hardly differed from the standard vaccine of 
to-day ; but so little did Woodville know the law of the 
pathological process with which he was dealing, that he 
actually allowed the cowpoxed arms in some instances 
to proceed to the fifteenth and even nineteenth day of 
their development before he inoculated from them ; and 
his venture was only saved from failure by a kind of 
empirical selective instinct which led him, in a wide 
field of choice, to continue his stock with matter that 
happened to stand for the early stage and the short 
cycle of cowpox. The smallness of the vesicle thus 
induced, the shortness of its cycle, and the mildness of 
its effects all served to divert the attention of Wood- 
ville from the true analogies of cowpox, and to fix it 
upon the false analogy which had been put into men's 
heads by Jenner's new-fangled name " Variola Vaccina." 
Woodville has traced the pedigree of inoculated 
cowpox through a number of generations, and has given 
in a table the names, ages, and other particulars of about 
four hundred and fifty cases. For the first two hundred 
cases, he professes to do more ; he gives information in 
the text under the name of each of them, but the infor- 
mation is often meagre as regards the state of the cow- 
poxed arm. Tiie record is on the whole an authentic 
one, and is at all events free from the suspicion of hav- 



io8 



COWPOX MADE MILD AND ACCEPTABLE. 



ing been "edited," which attaches to everything of the 
same kind published by Jenner. I can give here only a 
few results gathered from a study of his book.^ 

To begin with the strain of cowpox from which Jenner 
himself was supplied, and which became in his hands 
the source of "true Jennerian lymph;" at the first 
remove from the cow it was taken off as tenth-day 
lymph, at the second remove it was eighth-day lymph, 
and at the next remove it was taken off and sent to 
Jenner at the tenth day ; so that the vesicle was as if 
habituated to yield fluid from the eighth to the tenth 
day, and, as we learn from VVoodville's narrative, to have 
the efflorescence out on the ninth day, and the first 
appearance of the scab about the tenth. 

Of Woodville's numerous other concurrent strains of 
lymph, several came to an end, probably because the 
ripening of the vesicle got later and later ; whereas 
those which survived and sent out the most numerous 
branches were strains with a consistent record of early 
maturity. Thus, to take one from the same parent 
stock as Jenner's own : Collingridge (direct from the 
cow) ; Butcher (loth day) ; Jewell (7th day) ; Fisk (9th 
day) ; Murrcll (7th day) ; Hatt and Playford, each the 
vacciniferof many more, on dates not stated. A parallel 
strain to this had an obnoxious interlude, but came 
back, at the next remove, to a safe type : Collingridge 
(direct from the cow) ; Butcher (loth day) ; Jewell (7th 
day); Reed (loth day); Webb (15th day, had severe 
erysipelas) ; S. Timms, H. Timms, and Lee (loth day), 



I 



' Reports of a Series of Inoculations for the Variolm Va, 
CoTUpox. London, i^gg. 



VACCINATIONS WITH EARLY LYMPH. lOg 

each the vaccinifer of numerous others on dates not 
stated. 

These and other strains claimed descent from the 
cow direct. But Woodviile had also a stock of matter 
in currency which he toolf from the dairymaid's hand ; 
and there is something to be learned in following the 
fortunes of that, the more so that the original infection 
on the milkmaid's hand and arm never came to the 
usual painful ulcers of cowpox at all. Two men were 
inoculated from the dairymaid's vesicles at the fourth 
day, having been inoculated with smallpox the day 
before. Both infections ran their course independently 
of each other, and the cowpox vesicles proved to be of 
so early a type that they had actually scabbed before 
the variolous pustules did. Six others were inoculated 
from the dairymaid's vesicles when these were a day 
riper, of whom we have a somewhat different history. 
Three of them are unaccounted for altogether; of the 
other three, only one, James Crouch, aged seven, was 
used to continue a supply from. Let us take the three 
in order : 

William Harris, aged tweniy-one : on jtli day vesicle began ; 
on gth day it had prominent callous edges and depressed centre, 
but hardly any areola ; on I2tli day areola going off ; on I4tli day 
vesicle dry at the centre, but its surrounding edges of a hluish 
tinge and still abounding with ichorous matter ; igth day the cow-- 
pDx infection has become a dry scab, with a finely polished surface 
of a mahogany-brown colour — the standard or classical termination 
of vaccination, and a termination reached within a day or two of 
the usual time. We hear of no strain being continued through 
this highly favourable case. 

The next case from the dairymaid's vesicles at the fifth day is 
William Bunker, aged fifteen ; 8th day, vesicle has grown rapidly, 
pain in armpit with headache ; loth day, vesicle already scabbing, 



COWPOX MADE MILD AND ACCEPTABLE. 



the areola extensive ; nth day, the areola nearly gone ; 17th day, a 
dry scab all over ; 20th day, complete smooth brown scab. 

The case from which the stock was continued is James Crouch, 
aged seven : gth day, vesicle full of ichor, little areola ] inh day, 
the efflorescence extensive, vesicle drying at centre ; 14th day, 
pain in armpit, drying process extending. From this case one 
person was vaccinated on the twelfth day, and two on the thirteenth j 
the former, aged twenty-five, had a mild form of cowpox, but was 
rot used as a vaccinifer ; one of the latler, a child of twelve 
months old, had a very severe illness, and was likewise not used 
as a vaccinifer; while the remaining one, Edward Turner, aged 
twenty-four, was used to continue the stock of the milker's cowpox 
from. On the 12th day his two vesicles began to dry in the 
centre, but the margins were of a dark-red colour (areola), and 
studded with minute vesicles, same lime pain in armpit j 14th 
day, the inner edges of the vesicle distended with ichorous fluid. 
From that arm six persons were vaccinated on the sevenUenlh and 
nineteenth days ; the results are given with far too much brevity 
to be intelligible, but none of the six became the vaccinifer of 
others. 

Thus the straiti from the dairymaid's hand would 
have come to an end, only that the strange experi- 
ment had been tried of inoculating from it at the first 
remove (James Crouch) back to a cow's teat. It was 
through that indirect channel that the dairymaid's 
lymph passed into the main current of English vaccine ; 
the cow was infected (and gave infection to a man who 
milked her); from her, three persons were inoculated, and 
from two of these a numerous race of vaccinifers arose, 
whose several lymphs corresponded to the 8th, gth, 
or loth day of the cowpox cycle. 

It will thus appear that no lymph in Woodville's 
practice was passed into general currency if it was 
older than the tenth day. For some unexplained 
reason he allowed cowpox vesicles in several instances 



I 



JENNER SUPPLIED BY WOODVILLE. Ill 

> on to the thirteenth, fourteenth, fifteenth, six- 
teenth, seventeenth, eighteenth, or nineteenth days, 
before he took matter from them ; but in all those 
instances (excepting one that reached the fifteenth day, 
but was brought back at the next remove to the tenth 
day) the stock failed or was discontinued for one 
reason or another. 

Woodville's earliest vaccinations were on the sixth 
day; and that early lymph was got from two of his 
cases directly inoculated from the cow. That matter 
was procurable from them on the sixth day, means 
exceptionally early maturity. The sixth-day lymph 
produced good vesicles, which ended in the characteris- 
tic polished mahogany -colon red crust ; and no doubt 
lymph would have been continued from that good stock 
had it not been that the cases at the second remove 
were badly complicated with smallpox, which had been 
inoculated the day before the covvpox, and ran its 
course concurrently. 

After Jenner himself had made trial, in twelve 
cases, of the cowpox matter which Pearson sent him 
from Woodville's stock, he wrote to Pearson (13th 
March, 1799) : " The character of the arm is just that 
of cbw-pox, except that I do not see the disposition in 
the pustule to ulcerate as in some of the former cases." 
In his letter to Woodville, on receipt of the London 
lymph, he had spoken grandiloquently about his own 
trials, evidently for the purpose of making Woodville 
believe that he had been experimenting largely, and 
had as much vaccine lymph of his own raising as he 
wanted. As a matter of fact, he had none, having been 
baffled, every time he tried, by the ulceration of the 




1J2 COWFOX MADE MILD AND ACCEPTABLE. 

children's arms. He used the same disingenuous tone 
when he referred to Woodville's lymph in the Fiirtlier 
Observations, which came out in April following. 

The complications with smallpox, which troubled 
Woodville for the first few weeks of his vaccination 
practice at the Smallpox Hospital, gave Jenner his 
opportunity. He is, of course, addressing the public, 
who knew nothing of the private history of all these 
transactions as we now have it in letters and memoirs. 
He does not let them know that he was without cowpox 
matter until the 15th of February, when he got some 
from Pearson ; nor docs he say that it was from the 
letter wliich came with the London vaccine lymph 
that he first heard of the eruptions. " You will be 
astonished," Pearson had written, " at our talking of 
eruptions." Jenner wishes the public to believe that it 
was merely for the purpose of comparing it with his 
own (non-existent), that he tried Woodville's lymph ; 
" The matter they made use of was taken, in the first 
instance, from a cow belonging to one of the great 
milk farms in London. Having never seen maturated 
pustules produced either in my own practice among 
those who were casually infected by cows, or those to 
whom the disease had been communicated by inocula- 
tion, I was desirous of seeing the effect of the matter 
generated in London on subjects living in the country." 
That was the only reason for his making use of Wood- 
ville's matter — the only reason except that he was 
without lymph of any kind, having uniformly failed to 
continue a stock of his own. 

The same reason turns up again in his third pam- 
phlet, under equally disingenuous circumstances. Having 



1 



JENNER ATTEMPTS A STOCK OF HIS OWN. II3 

come to London to secure his rights in the spring of 
1799, and having found Woodville's lymph distributed 
universally, he saw the necessity of initiating a stock 
of lymph which might become the true Jennerian. The 
veterinary student, Tanner, who had assisted Woodville, 
was employed to get some cowpox matter for Jenner 
in London, if he could. This, Tanner is said to have 
succeeded in doing some time in April ; he brought it 
to Jenner, who — proceeded to raise his stock forthwith ? 
Not so ; he sent Tanner at once with it to Marshall of 
Eastington, who was carrying on the vaccine practice 
in Jenner's absence, and had at that time done more 
than a hundred vaccinations with Woodville's lymph. 
The matter was intended to be the source of the his- 
torical "true Jennerian lymph"; and it was sent off to 
a remote part of the country, where no one ever knew 
what happened to it, except Marshall himself. But this 
is all that Jenner says of his despatching it to the country 
and his declining to raise the true Jennerian stock from 
it, with his own hands or under his own eye, amidst the 
abundant opportunities that the population of London 
afforded ; " On the supposition of its being possible that 
the Cow which ranges over the fertile meadows in the 
vale of Gloucester might generate a virus differing in 
some respects in its qualities from that produced by 
Jhe animal artificially pampered for the production of 
milk for the metropolis, I procured, during my residence 
there in the spring, some Cow Pock virus from a cow 
atone of the London farms [Clarke's, in Kentish Town] 
It was immediately conveyed into Gloucestershire to 
Dr. Marshall, who was then extensively engaged in the 
inoculation of the Cow Pox, the general result of which, 



114 



COWPOX MADE MILD AND ACCEPTABLE, 



I 



and of the inoculation in particular with this matter, I 
shall lay , before my Readers in the following com- 
munication from the Doctor." ' Then follow two letters 
from Marshall, the first dated 26th April, 1799, and the 
second with the date [8th September] omitted, Mar- 
shall's only reference to the cowpox matter taken from the 
cow artificially pampered for the production of London 
imilk, so as to compare it with the corresponding virus 
taken from the animal which ranges over the fertile mea- 
dows in the vale of Gloucester — -a virus of which Jenner's 
own experience was by no means idyllic — is contained 
in a postscript to the second and undated letter, wherein 
this country doctor coolly observes that 127 vaccinations 
out of a total of 423 (or exactly 30 per cent.) were done 
with " the matter you sent me from the London cow," 
That is the whole evidence; as if the establishment of 
a stock of lymph from original cowpox in the cow were 
an easy thing, an everyday occurrence, and as if Jenner 
had not failed every time he tried 1 He goes on : " I 
discovered no dissimilarity of symptoms in these cases 
from those which I inoculated from matter procured in 
this country," Procured in this country ! Why, it was 
procured by Woodville from the cow in Gray's Inn Lane, 
"Artiiicial pampering" would have been much the same 
sort of thing in Kentish Town as in Holborn, It was 
wholly irrelevant to the problem in any case, and was 
a mere "blind." 

The special services of Woodville in making vaccina- 
tion practicable were recalled in 1802, when Jenner was 
abgut to receive ten thousand pounds from Parliament ; 



r 



RESEMBLANCE TO SMALLPOX. II5 



Pearson, and not Woodville himself, who strove, 
in vain, to clear up the historical sequence of events 
and the respective merits of parties. One of Pearson's 
remarks is as follows :^ " The acuteness of Dr. Wood- 
ville, and the obligations of the public to him, will be 
fairly appreciated by considering that he was led to 
expect, from Dr. Jenner's account, a quite differently 
appearing pock from what, I suppose, all the world now 
knows to be the fact." The circular figure, he explains, 
the smooth surface, the less pointed shape, and tha peadiar 
scab were first noticed as distinctive of the cowpox by 
Woodville and by Pearson himself. These are, indeed, 
great and sufficient distinctions of cowpox from small- 
pox, even if there had been no gulf separating them in 
their clinical history, and a stfll more insuperable barrier 
in the whole epidemiological history of smallpox, which 
Jenner knew nothing of. 

But Woodville's greater "acuteness" was nothing 
more than his greater honesty and candour. Jenner 
knew these differences between cowpox and smallpox 
well enough, indeed he knew of far more striking dif- 
ferences; only he took care not to dwell upon them. 
If any one scans his writings closely, he will find how 
dexterous Jenner had been in suggesting the identity or 
likeness of the cowpox with smallpox on indecisive or 
irrelevant points. It is the fever that is the same in 
the two, or the efflorescence, or the early changes in the 
appearance of the incisions. 



' An Examination of the Claims, etc., cdntaimng a Statement 
of the priruipal Historical Facts of the Veucinia,^. 104. London 



Il6 COWPOX MADE MILD AND ACCEPTABLE. 



Two references to the idei 



.'-question in Jenner's 
second pamphlet [Further Observations. April, 1799) 
are as follow : " Seeing that these sores [of cowpox] 
bear a resemblance to the Small Pox, especially the con- 
fluent, should it not encourage the hope," etc. ; and, 
" In my former cases \i.e., previous to getting matter 
from Woodville] the pustule produced by the insertion 
of the virus was more like one of those which are so 
thickly spread over the body in a bad kind of confiuent 
Small Pox. This [with Woodville's lymph] was more 
like a pustule of the distinct Small Pox, except that I 
saw no instance of pus being formed in it, the matter 
remaining limpid till the period of scabbing," ^ 

Woodville, then, passed into common currency a type 
of cowpox which was less unlike the smallpox pustule 
than Jenner's had been ; and, at the same time, he 
recognised the differences between his own cowpox 
and smallpox with more "acuteness" than Jenner (as 
Pearson said), or with more candour and honesty. By 
good fortune, as much as by technical skill in inoculating, 
he got rid of the ulcerous termination of cowpox, 
Jenner himself admitted that the cowpox produced by 
Woodville's lymph diflered principally in not having 
" the disposition to ulcerate as in some of the former 
cases" ; and Woodville said : " We have been told that 
I the Cow-pox tumour has frequently produced erysi- 

Ipelatous inflammation and phagedenic ulceration ; but 
the inoculated part has not ulcerated in any of the cases 
which have been under my care, nor have I observed 
inflammation to occasion any inconvenience, except in 



• 



I 



' Ed. 1800, p. 136. 



THE MILD TYPE MISLEADING. 1 17 

nstance, where it was soon subdued by the applica- 
tion of aqua lithargyri acetati. It would seem, then, 
that the advantages to be derived from substituting the 
Cow-pox for the Small-pox must be directly in proportion 
to the greater mildness of the former than the latter 
disease. "1 

These are the words with which Woodville ends his 
Reports of a Series of Inoculations, the authentic his- 
torical narrative of the establishment of cowpoxing 
on the great scale. His own good faith and genuine 
belief are everywhere apparent ; in those respects he 
represents, at the outset of vaccination, the state of 
mind which has been the common one among medical 
men regarding this practice. Cowpox is a milder 
disease than smallpox, and equally efficacious ; that is 
the sum and substance of the vaccinator's creed. The 
efficacy, as proved by the early evidence, falls to be 
considered in the next chapter ; we have here still 
something to say as to the rea! meaning of the mild 
type, which was as conspicuously present in Woodville's 
lymph as it had been conspicuously absent in Jenner's. 

The freedom from risk in vaccinations done on the 
great scale is, of course, a remarkable fact, when we 
bear in mind what sort of disease cowpox is. Of the 
eight hundred thousand infants infected every year in 
this country with cowpox virus, the vast majority escape 
very lightly. The mildness of type which Woodville 
accidentally found in cowpox, or skilfully gave to it, 
became a cloak for Jenner's numerous inconsistencies 
and evasions ; above all, it served to cover, much more 



COWPOX MADE MILD AND ACCEPTABLE. 



successfully than his own practice had done, or ever j 
would have done, the unwarrantable liberty he had 
taken in changing the name of cow's pox into smallpox 
of the cow. We shall never understand the merits of 
the vaccination controversy until we understand how 
the practice came to be adopted by the medical profes- 
sion, on the recommendation and by the practical 
endeavours of so honest a man as Woodvilie. It was 
not until forty years after Woodville's time that patho- 
logical experiment brought to light facts which explain 
how the illusions about inoculated cowpox had arisen ; 
although these facts have remained unnoticed in this 
connexion until I adduced them in a book on The 
Natural History of Cowpox and Vaccinal Syphilis}- 
The pathological experiments in question were those 
made by Ricord in Paris to inoculate the virus of 
syphilitic sores, or venereal pox, on the skin. If these 
and other experiments of the same kind had existed 
in 179S, the secret artifice of making cowpox first known 
to the profession under the name of smallpox of the 
cow would have been obvious at least to the pathologists, 
and would have been exposed in due course ; for it 
would have been shown conclusively that the affinity of 
cowpox was to the great pox of man. In the exercise 
of that scientific method, the pathologists would only 
have given proof to the profession of an affinity that 
the vulgar had originally recognised, without reasoned 
argument, when they called the sores on the cows' 
teats and on the milkers' fingers by the name of cow- 
pox : an affinity that Moseley also recognised by his 



' London, JS87, p. 34. 



H INOCULATED SYPHILIS. Iig 

natural shrewdness when he sought to stigmatise the 
new inoculation with the name of lues bovUla, in his 
first reference to it in 1798. 

One of the fullest narratives of the inoculation of 
venereal pox by Ricord is given in a communication to 
the first number of a German periodical called Syphi- 
lidologie, edited by Behrend. The narrative is from 
the pen of Dr. Selke, a German who was then following 
the hospital practice of Ricord, and who enjoyed excep- 
tional opportunities.' 

A young man with multiple primary sores, three of them in the 
state of small whitish blebs, came into the hospital for venereal 
disease at Paris on the 4th of May, 1835 ; he was inoculated 
next day (5th) on the skin of each thigh with matter from the 
primary malady — on the left thigh with matter from an unbroken 
bleb, and on the right with matter from one of the blebs which 
had meanwhile become an open sore. On the 6th a little pimple 
appeared at each spot, which was soon surrounded by an areola 
or zone of redness an inch in diameter. On the 7th the pimples 
changed into vesicles or pustules, and became seated upon a hard 
and elevated base. On the gth each pustule was an eighth of an 
inch in diameter ; and on ihe day after they began to change into 
brownish crusts, which on the nth were a quarter of an inch in 
diameter. Day by day the crusts grew thicker and broader, and 
on the 15th an ichor or watery matter was found oodng from 
beneath them ; on the 22nd and 23rd the ichor was a Ihin brown 
pus, and on the sglh was of a putrid odour. On the next day the 
crust on the left thigh, an inch and a quarter broad, came off after 
poulticing, and revealed a round ulcer, three-quarters of an inch 

' " I give this case," he says, " as I have seen it, and been 
enabled to note the successive changes in the patient's condition, 
from day to day. An English doctor studying in Paris, Dr. A. 
Thomson, and Dr Vernois, interne under Kicord, have also 
kept accurate journals of the case, which have been used by me 
to correct my own notes."— Behrend's Syfihilidologie, voL L 1839, 



120 COWPOX MADE MILD AND ACCEPTABLE. 



and a few large 
; in the centre of its dry yellow floor. 
I had formed upon it, which was again 
the 1st Ju. 



uid left i 



e of healing ; and 



in diameter, with raised, hard, bluish edges, 
yellowish -red granulatia 
The day after, a new cr 
detached by poulticing o 

Meanwhile the crust on the inoculated spot of the right thigh 
had remained adhering ; on the 5th June it was loosened round 
the edges, and on the 8th it came away, disclosing, not an ulcer, 
but another thin, reddish-brown crust or eschar, beneath which 
was an elevated growth or bouton three-quarters of an inch in 
diameter ; the thin under-crust or eschar became firmer and darker 
when it was exposed, and in the days or weeks following (for 
which the daily record is not given), it 
cavity to be filled gradually by granulationi 

The left sore had preceded it in the sami 
in both instances the induration had disappeared (without mer- 
curial treatment) and the healing had progressed to a cicatrix by 
the zoth July. The right inoculation was complicated by a second- 
ary sore on the skin near it, which began as a small pustule on 
the 8th of June, and was the last part of the ulcerative process to 
get healed. 

These are sufficiently typical instaiices of the be- 
haviour of an ulcerous specific infection when repro- 
duced on the skin by deliberate inoculation ; and they 
are exactly parallel to the Stroud inoculations with 
cowpox, in the last chapter (p. 96), The inoculated 
spot is first a pimple, which becomes a vesicle or bleb 
or pustule, and quickly passes into a scab. It is under 
the scab that the active process goes on for some time ; 
the scab may be removed (with the help of poulticing', 
if need be), a new scab will probably form, or an eschar 
be disclosed under the original crust, and the defect of 
substance will be at length filled up with granulations. 

For five-and-twenty years after that date numerous 
experiments were made in the inoculation of venereal 
virus upon the skin of the same subject, or in the way 



I 



ANALOGY WITH SYPHILITIC VESICLE. 121 

of practising the foolish craze for "syphiHsation"; and 
much was learned of the behaviour of a specific type of 
ulceration when so inoculated. The vesicular stage 
often reproduced the figure and colour of the cowpox 
vesicle almost exactly : that is to say, a large whitish 
spot of skin, tumid around the edge and less elevated 
at the centre, which became a scab ; in due time the 
scab would be thrown off" and reveal either an eschar 
filling the cavity, or an open excavation discharging a 
thin, stinking ichor. Mr. Henry Lee carried his in- 
oculations through several removes, and in a number of 
instances got the whole process to end with the scab, 
just as it does in ordinary inoculation with the pox of 
the cow's teats. The ulcerative phase might, in fact, be 
got rid of in the course of successive reproductions of 
the venerea! pox, as in the cowpox ; and it is significant 
that the cases of the former which Lee got to dry up 
from the vesicular stage, without ever passing into a 
phase of open ulceration, were cases where he had taken 
the matter for inoculation at a very early stage of the 
original sore.i Those who may desire to see how 
exactly an inoculated venereal sore in its vesicular stage 
can resemble the vaccine vesicle have only to look at 
Lee's plates.^ 

Ricord's plates^ show a great variety of similar 
appearances ; and we have that experienced syphilo- 
grapher's recorded opinion,* that the vesicula ror pustular 



' Mdd.-Ckirurg. Trans., xlii. (1859), p 439. 
' lb. xliv. (1861), especially fig. 3 of Plate II. 
' Maladies V^n^riennes, Paris, 1851. Plale I. figs. 6 and 7; 
Plate III. figs. 7, 8, and 9. 
* Reported l)y Diday, Traiti de la Syphilis des Nouveau-rUs el 



COWPOX MADE MILD AND ACCEPTABLE. 



Stage of a syphilitic infection, produced artificially on , 
the skin, might easily be mistaken for a pure vaccine 
vesicle produced under the same circumstances. 

In the series by Lee, among which there occurred his 
typical bluish-white vesicle with depressed centre, the 
succession was kept up to the third remove, "and the 
poison appeared quite as active and virulent at last as 
at first." What makes cowpoxing so unique a thing 
among inoculated infections is that it has been kept up 
through some thousands of removes, has been steadied, 
as it were, to a particular eighth-day type, and culti- 
vated into an artificial malady called vaccinia. It 
cannot be doubted that this was begun by Woodville in 
the boldness of ignorance, and under the illusion that 
he was really dealing with smallpox of the cow. It is 
singular that the boldness of ignorance should have 
come out so well as it has done; but, with all the 
average safety of cowpoxing in infants, there have been 
many reminders during these ninety years that the 
original type of cowpox is a foul ulceration and not a 
mere cutaneous eruption. These occasional reversions 
of type, in contrast to the average mild type of miti- 
gated cowpox, have been dealt with by me in my former 
book on the Natural History of Cowpox and Vaccinal 
Syphilis ; I advert to the subject here only in so far as 
it serves to explain how Woodville could have gone on 
in good faith propagating cowpox by inoculation, being 
misled by the name variol<e vaccinw, or smallpox of the 



des Enfiints ij la inamelle. Engl. Trans!. (iJew Syd. Soc.) London, 



THE VESICLE OF HORSE-GREASE. 12$ 

The advocates of horse-grease, in 1 800-1 803, as we 
shall see, were under the same illusion from their want 
of pathological knowledge. The tumid, whitish vesicle 
or bleb on a farrier's or stableman's hand was just the 
same as that upon a milker's, although the cow's pap- 
pox was far from resembling the horse's " greased " 
hocks either in causation, or in development, or in issue.^ 
The point in common between them was inveterate 
soreness through filth and neglect; and the infective 
discharges of each, summing up as they did the history 
or antecedents of the disease as it then was, brought 
out a process of infection on the human hand which 
began in each like the white blister of a burn, and in 
each generally became in due course a painful and 
corroding ulcer. Such being the admitted character 
of each animal disease at the fountain-head, it seems 
well-nigh incredible that medical men, with some preten- 
sions to a discriminating knowledge of the processes of 
disease, should have allowed Jenner's bold invention of a 
" smallpox of the cow," derived from horse-grease, to 
pass into current professional teaching. 

The fact that so unreasoned and nonsensical a doc- 
trine did become current suggests various reflections and 
vain regrets. Had there been in medicine some encou- 
ragement for the logical or dialectical qualities of mind 
which are the ground of authoritative position in the law, 
there would have been such a force of critical scrutiny 
brought to bear upon the project of cowpoxing as would 



^ Htr'ing (C^eder Kuhpocken an Kiihen, Stuttgart, 1839) speaks 
of the "slight similarity" between the two diseases, although the 
nfection of the human hand from each of them was the same. 



124 COWPOX MADE MILD AND ACCEPTABLE. 

have effectually unmasked the illusion about " smallpox 
of the cow," and brought the evidence on the protection 
against smallpox afforded by the ulcerous infection of 
the teats to its proper bearings. Of such critical 
scrutiny in the most authoritative circles, there wa^ 
none. The invention of the new name was artfully 
concealed and was never found out ; and under the influ- 
ence of the plausible idea which the name covered, the 
evidence of protection was accepted on terms which will 
seem incredibly loose to all who have not hitherto 
made acquaintance with the standard of logic in the 
medical profession. 




THE one great question which the profession had to 
satisfy themselves upon, after a stock of cowpox 
matter had been found by Woodville and distributed by 
Pearson, was whether vaccine inoculation warded off 
smallpox. There were other points supposed to be at 
issue, such as whether vaccine caused an eruption, 
whether vaccine inoculation spread contagion, and 
whether the operation was attended with risk to life ; 
but the main question was whether it answered the 
purpose that Jenner recommended it for. There were 
two ways proposed of getting an answer to the question, 
the way of experiment and the way of experience. 
Experience was, of course, the best test, but it was not 
usually the quickest. The profession wanted to know 
the value of the new protective as soon as possible, and 
they proceeded to test their first cowpoxed cases by 
inoculating them soon after with smallpox. That was 
the famous variolous test. 

No one seems to have discussed the validity of the 
variolous test as a proof of the protective power of 
cowpox for practical purposes. Jenner resorted to it 
as if it were a matter of course to do so ; and his 
example was implicitly followed. The principle of test- 



126 



THE VAKIOLOUS TEST. 



ing the force of one inoculation by means of a second 
was part of the current inoculation doctrine of the time. 
Men of the stamp of Daniel Sutton were accustomed 
to reassure their clients that they were safe, by showing 
them that a second, or third, or fourth inoculation pro- 
duced either no smallpox at all, or a less amount of 
smallpox than the first inoculation.^ The assur-ance 
given on these experimental grounds proved not un- 
frequently to be fallacious ; when the real trial came, it 
was not unusual for the inoculated to take tiie epidemic 
disorder just like their unprotected neighbours. There 
was no lack of sobering experience of that kind ; so 
that in Paris the inoculators lost credit, and in course of 
time almost ceased to find employment. 

After describing in a letter to a friend his first case of 
cowpoxing (James Phipps, 1796), Jeiiner goes on to say: 
*' But now listen to the most delightful part of my story. 
The boy has since been inoculated for the smallpox, 
which, as I ventured to predict, produced no effect" * 
He was tried again a few months after, when no effects 
were produced "on the constitution." Poor Phipps, as 
Jenner used to call him, was inoculated some twenty 
timesafter that, and never "took"; he was Jenner's show 
^ case of resistance to smallpox ; he was a poor consump- 

L tivc or scrofulous youth, with his lymphatic glands so 
clogged (after the cowpox .'), that any subsequent iriocu- 

Ilatiqn of virus on the arm had no chance of being 
absorbed.^ 
M, 



' W. Langton, M.D,, Ati Address to the Public on Ike Present 
Method of Inoculation. London and Salisbury, 1767. 
' Jenner to Gardner, Baron, i. 
' Baron, ii. 30^, 



W FAILURES AT STKOUD. 127 

The Inquiry contained only two, or at most three 
other variolous tests done on vaccinated children ; 
Jenner rushed off to London to get it printed, without 
waiting to apply the test himself, but his assistant 
applied it in two or perhaps three of the cases. Even 
careless readers could hardly have been satisfied with 
the evidence, so far, that the vaccinated were " for ever 
after secure from the infection of the smallpox," as 
Jenner boldly alleged. When he went back to the 
country, after launching his discovery, he applied the test 
to one other vaccinated child, and produced the local 
pustule, the eruptive fever, and a transient eruption on 
the wrists. Jenner did not inoculate his Stonehouse 
cases (in December, 1798) with smallpox; but the 
Stroud doctors put all their ten cases religiously through 
the test, with the singular result that the only one of 
the ten, an adult, whose vaccination had not held, was 
the only one who stood the test, while the other nine all 
had smallpox in one degree or another, in the usual 
inoculated form, the two who had the worst vaccinal 
ulcers having stood the test rather better than the 
others. 

By way of a control upon Jenner, the independent 
evidence from Stroud was not encouraging. The next 
evidence was that which Woodville's continuous series 
of cases enabled him to supply on the grand scale. He 
carried on his vaccinations at the old Inoculation 
Hospital, in an atmosphere of smallpox contagion ; so 
that cowpox had a great opportunity of showing its 
protective power, Jenner had hastened to advise Wood- 
ville to inoculate those patients with smallpox who 
might " resist the action of the cowpox matter " ; and 




THE VARIOLOUS TEST. 

Woodville did inoculate several a few days after they 
had been vaccinated. Even those who did not resist 
the action of cowpox, but on the other hand developed 
full and correct vesicles, acquired the smallpox also, 
either by inoculation or by contagion. Thus, Ann 
Bumpus, from whose vaccine vesicles Jenner's own stock 
of lymph was procured, sickened for natural smallpox 
on the tenth day from her vaccination and had 310 
pustules of that disease on the fifteenth day. Her 
immediate vaccinifer but one, Jane Collingridge, was 
inoculated with smallpox on the fifth day after vaccina- 
tion, and had an eruption of 100 to 200 variolous pus- 
tules. These experiences were frequent in the first 
weeks of Woodville's practice with cowpox in the 
atmosphere of the smallpox hospital. Woodville was so 
sure of the protective power of cowpox that he tried to 
explain the eruptions m every way but the right one. 
" I did not conceive it to be possible," he wrote, "till 
after I had made repeated trials of the new inoculation 
out of the hospital ; nor is the fact to be easily ex- 
plained," etc.^ 

At length it was admitted that cowpox did not 
prevent smallpox if both infections were received to- 
gether, or if the cowpox had uo more than a few days' 
start ; the protection from smallpox was only established 
in the system when cowpox had run its course, and pro- 
duced its full constitutional action. The system was 
supposed to have been, as it were, touched profoundly 
by the virus of cowpox, and to have been rendered in- 
sensible to the action of smallpox for ever after. No 



' M^d, and Phys. Joum., Dec, i8oa 



EVIDENCE ON THE GRAND SCALE. 129 

one was able to explain how an infection that was so 
unlike in kind to smallpox as to run its full course while 
the latter ran its full course also, could become an 
antagonistic influence in the years succeeding, when 
nothing remained of it but a scar ; indeed, the pro- 
phylaxis was candidly acknowledged, as we shall see, by 
those who thought about it at all, to be of the nature of 
a mystery. 

Woodville put all his cases through a variolous test 
shortly after the cowpox infection was over, including 
even the large number of his cases who had gone through 
the smallpox itself concurrently with the cowpox. They 
all stood the test equally ; and these cases, to the number 
of several hundred, formed the nucleus of the great body 
of English variolous tests which tlie Germans and others 
were fond of adducing as a grand total of evidence, 
behind which it was unnecessary for most doctors to go. 
Pearson also wrote that he had " inoculated many scores 
with smallpox matter after the vaccine disease, and 
never with the effect of exciting the smallpox." He 
adds, however: "I have, indeed, been desired to see 
even some of my own patients who, I was acquainted, 
had taken the smallpox ; but these cases turned out to 
be either those in which the cowpox had not in reality 
preceded, or they were cases of merely local affection 
from the inoculated smallpox." ^ Jenner's friend, 
Marshall, of Eastington, wrote that he had tested 211 
out of his total of 423 (as nearly as possible fifty per 
cent.), but found that every one was protected." This is 

' Med. and I'hys. /mim., ii. (Oct., 1 799), p. 2 16. 
' Lund. Med. Hev.^m. [March, 1800). 



1 130 



THE VARIOLOUS TEST. 



P 

i 



the same Marshall who declared that 127 out of his 
total of 423 (as nearly as possible thirty per cent.) weie 
vaccinated with lymph of his own raising. 

Evidence from various parts of the country soon began 
to appear in the medical Journals, Evans, of Ketley, 
near Shiffnal, had vaccinated successfully sixty-eight 
persons, of whom thitty-nine had vaccinal eruptions and 
several had troublesome ulcers ; of these he tested twelve 
with smallpox, and found that they resisted it.^ Even 
when the vaccinated did not resist smallpox inoculation, 
it was not thought of much account. M. Ward, surgeon 
to the Manchester Infirmary, sent the following scries 
. of cases," and "congratulated mankind " on llie success 
of cow pox : — 

Case. I.— i6lh April, girl aged 7, successful vaccinalicn (oblong 
vesicle on I3(li day, full of limpid fluid and surrounded by areola) ; 
was thereafter inoculated with smallpm:, and had the disease in 
the confluent form (t6oo to 1800 pustules). 

Case II. — infant aged nine months, brother of No. i. Success- 
ful vaccination at two points (one healed on isth day, other 
covered by crusi, which became a superficial ulcer after the 2i5t 
day and yielded ichor up. to the 32nd day). Caught the smallpox 
from his sister,and had about 50 pustules, mostly on his face, which 
began to show about the 35ih day from his vaeciraiion. 

Case III. — Aged ; months. Vaccination did not hold. Variola- 
tion did hold. 

Case IV.— Aged J years. Did not take vaccine. Did not take 
smallpox after two trials by inoculation. 

Case V. — Aged 9 months. Did not take raccine. Did not take 
Hnallpox at twice. 

Case VI.— Aged 3 years. Did not take vaccine- Did not lake 



' Med. md Phys. Jou 
« Med. and Phys. Jeu 



134, paper dated I3th July, 1799; 



A SUBJECT OF CONGRATULATION. 131 

"smallpox. Variolation had failed, beyond local inflammation, 
when tried four months before. 

Case VII, — Aged 5 months. Vaccination failed, though tried 
liviee. Variolation failed, but arm swelled. 

Case Vi II.— Aged 16 months. Successful vaccination (areola 
on nth day, very extensive, with much fever). Variolated on the 
29th day, without result. 

Case IX.— Aged 19 weeks. Successful vaccination (slight 
vaccinal eruption on arm). Variolated on the 12th day, local 
pustule on the 19th day, eruption (of thirty pustules) on the 23nd 

Case X. — Aged 14 weeks. Inoculated from Case i., evidently 
with the coexistent smallpox matter mistaken for cowpox. Sickened 
on 7th day, eruption of smallpox on 10th, full burden on (2th, but 
not confluent Variolated on the i+th day without result. 

Case XI. — Aged g months. Also inoculated from Case i. (com- 
plicated with smallpox), with same result as in Case x. 

C\SES XII., XIII., and XIV.— Results not kno\¥n. 

Ward was highly pleased with this record of tiie 
variolous test. What are vvc to think of the temper of 
the profession at this time, when a respectable practi- 
tioner congratulates the world upon a great discovery, 
with failure staring him in the face from the record of 
his own experience? Only one of all his cases resisted 
variolation after being cowpoxed, ilamely Case viii. ; three 
cases took smallpox in the clearest way after being cow- 
poxed (Nos. i., ii., and ix.) ; four cases resisted vaccina- 
tion, and likewise resisted variolation ; one case resisted 
vaccination, and received' the subsequent variolous in- 
fection ; and two cases were apparently variolated in the 
first instance by misadventure. 

Some practitioners were shaken in theirfaith when the 
variolous test failed. One of these, Shorter, of EJo.vham, 
near Banbury, wrote to Jenner that he had succeeded in 
producing the correct variolous pustule at the place of 



M32 



THE VARIOLOUS TEST. 



insertion in recently vaccinated cases ; but Jenner's 
"gentleman-like letter removed all my doubts, and I 
have again resumed the practice."' Another, Bodding- 
ton, found, in the case of his own child, that the test 

I produced not only the local pustule, but also the general 
smallpox eruption. Jenner, in reply, gave him a 
tremendous wigging : ' " How a gentleman, following a 
profession the guardian angel of which is fame, should 
have so committed himself as to have called this a case 
of smallpox after cowpox is not only astonishing to me, 
but must be so to all who know anything of the animal 
economy." This, as Baron says, is a good illustration 
of Jenner's "method of dealing with rumours of that 
kind." Beyond all question, the eruption was the due 
consequence of inoculating with smallpox virus. 

r Jenner's bullying attempt to refer it simply to the child's 

I tender skin should be pondered by all who believe his 
reasoning powers to have been masterly. 

The variolous test, with such validity as it had, was 
not applied at all generally in England after the first 
weeks of cowpoxing in the spring and summer of 1799. 
The total of some two thousand successful English tests, 
which got extensively quoted abroad and helped greatly 
to recommend the new practice, was made up of Wood- 

f viUe's hundreds, of Marshall's two hundred odd, of 
Pearson's scores of cases, and of other large aggregates, 
for which the details were never given. Whenever we 
have the opportunity to scrutinize the actual sequence 

I of events, we find that the inoculation of smallpox was 



' Med. and Phys. Joum., iii. 348. The let 
I of Jenner's wheedling manner. 

' Jenner to Boddington, 2ist April, 1801, in 



I sample 






THE AVERAGE EXPERIENCE. I33 

nearly always followed by some degree of local action 
and in most cases by a full and correct variolous pustule. 
It was chiefly the eruptive fever and the general eruption 
which aborted or remained in abeyance. A common 
experience, probably the average experience, was thus 
stated in a letter to Jenner by W. Forbes, of CamberweU, 
who had applied the test a good many times : ' 

" Although the variolous inflammation perfectly 
succeeded, and, I have no doubt, would have infected 
others inoculated with the fluid secreted, yet the con- 
stitutional progress was as completely arrested as if the 
patient had gone through the smallpox before." 

In their indifl'erence to the production of local small- 
pox in testing the virtue of cowpox, and to any slight 
show of eruptive fever, the profession betrayed a 
singular facility for dropping all at once a mode of 
reasoning that they had made great account of under 
the old inoculation regime. The slight effects of the 
smallpox inoculation, mostly the local effects, which 
were thought nothing of when the inoculation was done 
to test the protective virtue of preceding cowpox, had 
been held of the utmost account, had been carefully 
noted and liberally appraised, when inoculation was an 
end in itself, or when it was done in the ordinary way 
of pre-Jennerian protection. In order to make clear to 
modern readers this use of a double standard of what 
constituted effective variolation, it will be necessary to 
go back some thirty years prior to the advent of Jenner, 
The digression will be of some length, but the import- 
ance of the subject will perhaps be found to Justify it. 



134 



THE VARIOLOUS TEST. 



The years from 1764 to 1767 saw the rise of a "new 
method" of smallpox inoculation in England, and a 
lively controversy thereon. Whatever may be urged 
against the discretion and wisdom of the medical men 
who took up the practice of inoculation after it was first 
introduced from Turkey by Maitland, at the instance of 
Lady Mary Wortley Montagu, in 1721, it can hardly be 
said that they scamped their work. They seem to have 
given a considerable dose of the inoculated smallpox 
either unavoidably or of choice,' with the intention of 
anticipating the attack of it in the ordinary way of 
endemic or epidemic contagion. The severity of the 
engrafted disease was a serious bar to the general 
adoption of this Turkish and beauty-saving artifice ; and 
in a few years it fell into considerable disrepute. From 
the depths of its unpopularity it emerged shortly after 
to enjoy a qualified success; and from the year 1764, 
when the Suttonian method was introduced, it continued 
in vogue in England until it was superseded by Jenner's 
cowpox. Of the method as practised before Sutton's 
and Dimsdale's time, we may take our impressions from 
the well-written essay by James Burges.^ 

The obvious thing in the essay of Burges is his 
anxiety to bring out the eruption, to give it facilities for 
coming out, and to obviate whatever would tend to 
repress it or " repercuss " it. The Eoerhaavian pathology 
of the time was used as the scientific justification of 

' See Nettleton {Pfiihs. Trans, of Royal Sec, 1722) and other 
authorities cited by White in Sfery of a Great Delusion. London, 
1885, p. 50. 

' The Preparation and Management necessary la Inoculation. 
London, 1734. 



OLD-FASHIONED VAKIOLATION. I 35 

these coramon-sense aims. Warmth in bed was advised, 
lest the externa! air should " obstiuct the exclusion of 
the infectious matter." The apartment was not to be 
"so open and cool as to produce a degree of chilliness 
sufficient to check those sweats that are in this state 
quite necessary for bringing out the eruption." Agaiu, 
the cold of winter, "by obstructing the pores and con- 
stringing the vessels, brings such an overcharge on them 
that they become unable to get rid of the load " ; and 
the extreme heats of summer had somehow the same 
obstructive effect in another way. One great risk of 
" repercussing" or driving back the eruption was that 
the habit for long after would be clogged or encumbered 
with "obstructions." Another common-sense risk was 
thus technically expressed by Richard Holland in 1728: 
" In a genuine and complete eruption, the matter of the 
disease is entirely evacuated, and therefore there is no 
possibility of a return. But in an imperfect crisis, part 
of the original cause may remain." ^ 

It was only when the general eruption of the en- 
grafted smallpox was checked by a chill or other acci- 
dent that the early inoculators counted it a failure ; if 
the pustules died away, or came to nothing when due 
care had been taken, it meant that the habit was a 
favourable one, or that there was a natural disposition 
to take the disease mildly. But in Burges we may no- 
tice also the first insidious beginnings of a mode of 
reasoning which was carried to great lengths a few years 
later. The original practice in England was to insert 

' Obserimlion on the Smallpox and a more effectual Method of 
Cure. London, 173S. 



1^6 THE VARIOLOUS TEST. 



the smallpox matter at a quite large and deep i 
in the arm, and, in some instances, to keep open the 
sore so produced as a rendering issue for weeks after, 
liven if no effort were made to keep the original in- 
cision an open sore, it might go on rendering for some 
time. In such cases, as Surges says, "the extent and 
duration of the primary variolous insertion would seem 
to have checked the general eruption " ; and he gives a 
particular instance where the primary spot sloughed, 
gradually widened, and continued to discharge for six 
or seven weeks, so that no general eruption took place 
at all. But now let us carefully observe the significance 
that Burges puts upon this abeyance of the eruption : ^ 
" But if the sores keep open, and the feverish symptoms 
come on at the usual time, though not a single pustule 
should appear, I am convinced that the patient is as 
secure from ever having the smallpox as if there had 
been a plentiful eruption ; at least there is no instance 
that has ever been produced where it has happened ; 
.even though the utmost endeavours have been used to 
procure a second infection on a supposition that the 
first had been imperfect." " 

Other means, preferable to an open sore on the arm 
rendering matter for weeks, were soon found to keep 
back the general eruption, without impairing the value 
of the protection given by the single representative 
local pustule. This was the " new method " of inocula- 



' L. c, chapter xv. p. 41. 

' The stock instance in the books is that of the Hon. John 
Yorke, inoculated (without eruption) by Mr. Sergeant Hawkins at 
the age of twenty, and re-inoculated in vain. 



THE NEW METHOD. I37 

tion, begun in France by the famous inoculator Angelo 
Gatti, practised in England to their own enrichment 
by Daniei Sutton and by Dr. Dimsdale, of Hertford, 
and, after a vain remonstrance by two or three staunch 
men, generally approved by Sir George Baker, Sir 
WiUiam Watson, and other leaders of the profession 
in the latter half of the eighteenth century. 

Gatti found respectable or scientific reasons for the 
vulgar charlatanism of old women in the Levant. Sir 
George Baker approvingly quotes him to this effect 
(1766);^ "In the Levant old women have inoculated 
ten thousand people without an accident. They only' 
ask : Is the person prepared by nature ? Is the breath 
sweet? Is the skin soft.' Does a little wound heal 
easily? Then the inoculation maybe undertaken with- 
out the least fear of danger." These were the only 
conditions made by the old witches of Mussulman 
countries ; but the conditions were the quintessence of 
craft, whether Sir George Baker knew it or not. They 
meant no less than a selection of such subjects as ex- 
perience had shown to be likely to have the milder 
form of smallpox by inoculation ("prepared by nature," 
forsooth ! ). Gatti, in the exercise of his art in France, 
could hardly pick his cases by the divination which old 
women in the East were privileged to exercise ; but he 
always endeavoured to make the inoculated disease as 
mild as possible. Instead of making a large incision, 
and laying the matter therein upon a thread, he made 
a small oblique puncture with a lancet point and in- 



' Iiigiiiry into the Method of Inoculixting the Smallpox. London, 
1766. 



138 



THE VARIOLOUS TKST. 



serted the minutest quantity of matter. Moreover, he 
took- the matter from as early a stage of the natural 
smallpox as any fluid could be got at all, and from the 
mildest case ; and, improving upon that, he at length 
transferred matter from the early vesicle of one inocu- 
lated arm to another person's arm, and so on through 
a series of cases from arm to arm. He dropped the 
old treatment that had been used to "bring out" the 
eruption ; and, by keeping the patient's hand immersed 
in cold water, he often succeeded, with the help of his 
other arts, in limiting the whole process to the primary 
smallpox pustule at the plaGe of insertion.^ 

For some time Gatti did a large business in his "new 
method " of inoculation, amassing a fortune and ac- 
quiring fame. At length an accident happened in the 
case of a great lady, the Duchesse de Boufflers. Two 
years and a half after being inoculated by Gatti, and 
assured by him of protection, she had an attack of 
smallpox, which made a great noise. Her inoculated 
protective disease had consisted of the local pustule, 
some abortive pimples round it, an abortive fever on 
the eleventh day, and one large pustule on the forehead 
which left a mark visible for long after. About the 
same time, many other persons in Paris, who had been 
inoculated by Gatti, confidingly exposed themselves 
among the sick during an epidemic of smallpox, with 
the result that they caught the disease in large numbers, 
and not a few of them died of it. These accidents made 
an end of Gatti's credit, and the practice of inoculation, 



I 



' See the summary of his practice ii 
cination. Leipiig, 1B75, p. 82. 



Uohn's Handbuch der Va, 



DANIEL SUTTON. 139 

Stever method, was forbidden in Paris by a statute 
of the Parliament. 

In England it fared otherwise with the new method 
of "buying the smallpox" on the easiest terms. The 
method was much the same as Gatti's, with some addi- 
tional conjuring by means of secret pills and powders, 
which were at length found to be calomel and antimony, 
the theoretical Boerhaavian "antidotes" to smallpox. 
According to Daniel Sutton's advertisement, which he 
put out in the form of a sermon (with appendix) by a 
chaplain in his pay, the patients in his establishment at 
Ingatestone "have in general little or no sickness ; their 
indisposition is so trifling that they are ashamed to 
complain, and in a few days they are perfectly well. 
Here is no confinement, no keeping of bed. All is 
mirth, and all seem happy. If any patient has twenty 
or thirty pustules, he is said to have the smallpox very 
heavy." ^ According to Chandler, however, this was 
merely the tempting bait ; for some of Sutton's patients 
had a more copious eruption, despite all his efforts to 
keep it back, 

Daniel Sutton quickly made money, and in 17G6 
he was followed by Dr. Dimsdale, of Hertford, who 
also made a fortune and became a banker in Cornhill. 
Dimsdale gave a tolerably candid account of his prac- 
tice. He inoculated many of his patients a second 
time, and produced the same local pustule as before, 
but without fever. Others had symptoms of the erup- 
tive fever (on the first trial), but no pimples. " In 

' Rev. R. Houllon, Sermoft in Offence of Inoculaiion. Chelms- 
ford, 1766. Appendix, p. 40. 



140 THE VARIOLOUS TEST. 

many instances of cases related by the doctor, on going 
home the smallpox seeds were brought forward, and the 
disease appeared in the usual stages."^ 

The "new method " of making inoculated smallpox 
easy not only took the fancy of the public, but soon 
found vindication in the profession. Ruston, Giles 
Watts, and others published on it ; according to Watts, 
"a most extraordinary improvement is made, and the 
art of inoculation is enabled to reduce the distemper 
to almost as low a degree as we could wish. . . . 
There is now an opportunity of seeing what a very 
small number out of the multitude of persons of all 
ages, habits, and constitutions, who have been inocu- 
lated in these parts [Sussex and Kent] have been ill 
after it." ' 

The opposition to the new method was confined to 
a few, notably William Bronifeild, an eminent court 
surgeon, and Dr. Langton, of Salisbury. Bromfeild, in 
an essay dedicated to the Queen, reminded his col- 
leagues of the general tendency in medicine towards 
credulity, and remarked that even the French had 
passed through a fit of the same ; for it was mere 
credulity on their part "to have given credit to a man 
[Gatti] who should assert he would give them a disease 
which should not produce one single symptom that 
could characterize it from their usual state of health." 
He was "afraid that inoculation, though hitherto a great 



' W. Bromfeild, Thoii^^kts on the Method of Treating Persons 
Inoculated for the Smallpox. London, 1767. 

' Giles Waus, M.D., ^ Vindication of the Method of Inocula- 
ting the Smallpox. London, 1767, p. v. 



I 



PROTESTS AGAINST BOGUS INOCULATION. 14! 

blessing to our island, will in a very short time be 
brought into disgrace," if people went on believing 
"that health and security from the disease can be 
equally obtained by reducing the patients so low as 
only to produce five to fifteen pimples." He had been 
told (what was the fact) that " many lost their lives in 
Paris, after the epidemical phrenzy for inoculating in 
the new way there, which in general neither occasioned 
fever nor eruptions." If they could see the new method 
only in the light of its mildness, it would be unpardon- 
able prejudice to oppose it ; but did it really give pro- 
tection from smallpox?' 

Dr. Langton was even more alive to the illusory 
nature of the new practice. He issued an Address to 
the Public on the present Method of Inoculation, proving 
that tlie Matter communicated is not the Smallpox, be- 
cause Numbers have been Inoculated a second, third, 
and fourth Time, that therefore it is no security against 
a future Infection? After quoting the case of the 
Duchesse de Boufflers, he says that "not above one in 
ten have so many variolous symptoms as may be re- 

' Bromfeild, l.c., 1767, pp. 43-5. His own inoculation practice 
at Court was attended with disasters. Prince Octavius, youngest 
cliild of George III., died of inoculation. In other cases within 
the Court circle, the inoculation by Bromfeild, severe though it 
was, proved 10 be no security. See Court and Private Life of 
Queen Charlotte, being the Journals of Mrs. Papendick. London, 
1887, i. 41, 70, 370. In a letter to James Moore, who was writing 
a history of vaccination, Jen ner says : '"The late Mr. Bromfeild 
abandoned the practice of inoculation in consequence of its failure. 
Is not that a precious anecdote for your new work?"— Baron, ii. 
401. 

^ London and Salisbury, 1767. 



■ 142 THE VARIOLOUS TEST. 

marked in !ier case."' Besides the local pustule, there 
were usually only one or two pimples, or watery vesicles, 
which never maturated. 

Bromfeild and Laiigton were not supported by the 
academical leaders, who, as usual, found it politic to go 
with the stream. The principal spokesman was Sir 
George Baker, afterwards president of the College of 
Physicians, who had no objection to the practice of 
Daniel Sutton provided it were not kept a secret. He 
waxed eloquent on the invariable plea of the more 
stolid Englishman, the plea of giving the novelty a 
trial. " He is an enemy to improvement," said Baker, 
"and is no philosopher, who fastidiously and upon mere 
speculation rejects what he has not brought to the test 
of experiment." To the test of experiment, accordingly, 
they all set about bringing Sutton's quackery ; with the 
usual result that, in a very short time, their self-love got 
involved in the issue of the experiment, and a course of 
dogmatics and apologetics, or what is commonly called 
hard swearing, was entered upon so as to circumvent 
the teaching of common sense. 

The mere formality of smallpox, as gone through by 
the new nnethod of inoculation, was held to be a suffi- 
cient protection from the epidemic contagion. It be- 
came at least the object of inociiiators, even if they did 
not always succeed, to attenuate smallpox to the shadow 
of its real self. Such was the respectable practice in 
England during the latter part of the eighteenth cen- 
tury. In 1796, only two years before cowpox came on 
the scene, Woodville published the first (and only) 
volume of his History of the Inoadation of the Smallpox 



PROTECTION BOUGHT CHEAP. 143 

in Great Britain, wherein he carries the developments 
of the practice down to the adoption of Dimsdale's mild 
methods. A sentence in the preface gives us a glimpse 
of Woodville's own aims ; new researches, he says, are 
needed, because "the established process [Sutton's and 
Dimsdale's] will, in certain cases, not only fail of suc- 
cess, but evidently produce the disease in a?i aggravated 
state." We have further evidence of the contemporary 
mode of variolation in the handbook published as late as 
1806 by Lipscomb, the third in succession of a noted 
family of inoculators.^ Matter should be taken, he 
advises, as soon as any fluid can be obtained from the 
eruption in a mild case of natural smallpox ; the patient 
should be kept out of bed and as much as possible in 
the open air, particularly during the eruptive fever. If 
these precautions be observed, "the complaints are 
usually very trivial during the eruptive stage ; the 
patient eats and sleeps well ; a few pustules may appear, 
irregular and dispersed." 

Such was the kind of protective smallpox inoculation 
deliberately aimed at, and in the majority of cases 
accomplished, under the regime of the "new method," 
which dated in England from 1764. There is no reason 
to suppose that the earlier and severer type of inoculated 
disease was ever re-ititroduced of purpose into English 
practice, although there may have been old-fashioned 
inoculators here or there; and there probably were 
always a few cases which turned out more severe than 
the inoculator had intended or had thought necessary. 
In Jenner's time the type and mode of iiioculation were 
those of Sutton and Dimsdale; his near neighbour, 
' Manual of Inoculation. London, 1806, p. 8. 



I I44 THE VARIOLOUS TEST. 

Fewster, of Thornbury, had actually been a pupil of 
Sutton in the inoculation business. 

But we have clear enough evidence of what Jenner 
himself understood by variolous inoculation, and wished 
others to understand by it, in its new use of testing the 
strength of cowpox. The Inquiry of 1798 contains a 
few pages devoted to the subject of smallpox inocula- 
tion, which are introduced with a very definite purpose, 
although that purpose is nowhere explicitly stated. 
We suddenly find ourselves reading about "varieties of 
smallpox," from which we pass to one variety that had 
occurred in the inoculation practice of "a medical 
gentleman, now no more," which variety was "certainly 
not the smallpox" at all. The deceased inoculator had 
some special way of managing matter; "so strongly 
persuaded was he that he could produce a mild small- 
pox by his mode of managing matter that he spoke of 
it as a useful discovery until convinced of his error by 
the fatal consequence which ensued."^ The matter 
produced the local pustule or pustules, swellings of the 
glands in the armpit, the ninth-day fever, and "some- 
times eruptions"; but it so happened that epidemic 
smallpox broke out in the locality, and "many unfor- 
tunately fell victims to it who thought themselves in 
perfect security." 

Jenner recalls the incident (which was of a kind 
common enough everywhere) in order to suggest that 
these inoculations had been spurious: "But what was 
the disease? Certainly not the smallpox," This is 
very like the staunch language of Langton and Brom- 




now JENNER WORKED THE TEST. 145 

feild, who protested against all modes of "managing 
matter" with a view to make the inoculated disease a 
mild or formal affair. That, however, was not Jenner's 
suggestion ; the spuriousness and inefficacy that he 
wishes to guard liis readers against, with a view, how- 
ever, to the variolous test of cowpox, and not to inocu- 
lation for its own sake, were due to the fact that the 
variolous matter had not been "managed" enough; it 
had undergone some (purely imaginary} "putrefactive" 
change from being taken at too advanced a period of 
the smallpox pustules. He points out how careful he 
had himself been to avoid such causes of "spurious- 
ness" in trying the variolous test upon cowpoxed 
milkers : — 

" In some of the preceding cases I have noticed the 
attention that was paid to the state of the variolous 
matter previous to the experiment of inserting it into 
the arms of those who had gone through the cowpox. 
This I conceived to be of the greatest importance in con- 
ducting these experiments" No doubt of the greatest 
importance. And what was the attention that he paid 
to the state of the variolous matter previous to using it 
for the proof that cowpoxed milkers could not take 
smallpox? It is only in one of the "preceding cases," 
not in "some," that any notice is taken of the point ; 
but that notice is quite significant enough of what this 
super-subtle genius wanted to hint to his readers. Case 
iii. : John Philips, a cowpoxed milker, aged sixty-two, 
was tested with smallpox, the matter having been 
"taken from the arm of a boy just before the com- 
mencement of the eruptive fever." Just so; the 
variolous test was applied in the most mitigated form 



t46 



THE VARIOLOUS TEST. 



of Gatti's and Sutton's " new method " ; the matter for 
inoculation was taken from the local pustule of a pre- 
vious case of inoculation, not from a general eruption of 
natural smallpox ; it was taken at an early stage, before 
it had undergone the supposed " putrefactive " change 
which made it spurious; and it was inserted, not by a 
deep incision, but by a superficial puncture, as well as 
in small quantity. 

Very few modern readers of the Inquiry will see the 
drift of those pages in it devoted to the modes of vario- 
lous inoculation unless they read them with especial 
care. The subject was not introduced for nothing ; 
these portentous warnings about "much subsequent 
mischief and confusion " (p. 56), if attention were not 
paid to the state of the variolous matter used for inocu- 
lation, were merely Jenner's way of creating a preference 
for the ultra-Suttonian method of inoculation, when the 
variolous test was to be applied to his new project. It 
was in that way that he had himself applied the variolous 
test; it was in that way that he wished others to apply 
it; and there can be no doubt that it was after the 
Suttonian method that it was generally applied in 
proving the protective power of cowpox. 

We come, then, to this extraordinary result, that the 
very same degree of smallpox infection, namely, the 
local pustule alone, or the local pustule followed by an 
abortive fever and a few abortive pimples, which had 
come to be reckoned a sufficient manifestation of tlie 
disease when inoculation was an end in itself, was now 
reckoned an insufficient manifestation, and, in fact, an 
evidence that the infection had not taken at all, when 
inoculation was done after cowpoxing and with a view 



WITH A DIFFERENCE. 147 

to test the alleged antagonistic power of the latter 
against smallpox. 1 am aware of the gravity of that 
accusation against the common intelligence and moral 
prudence of the medical profession on the occasion, 
when they were asked to deliver judgment on Jenner's 
novelty. Every allowance should be made for the 
position that they were placed in with reference to the 
new protective disease. As Dcnman tells us, hardly 
any of them had ever heard even the name of cowpox 
before ; it was sprung upon them by a practitioner of 
the dairy-farming districts, who was treated with un- 
usual deference because he happened to be a fellow of 
the Royal Society, and had the air of being a modest 
and honourable man ; it was sprung upon them under 
the invented name of variola vacdntz, or "smallpox of 
the cow," which, for all they were ever told, might have 
been an ancient designation. The profession were 
undoubtedly mystified and hoodwinked about the true 
nature of cowpox ; they were started off on an entirely 
false analogy by Jenner's adroit title-page. But I can 
find no excuse for their conduct over the testing inocu- 
lation with smallpox, on the result of which it was 
generally agreed that the verdict was to turn. If any 
of my readers or critics, having taken the trouble to go 
over the evidence at first hand, will make out a case 
more favourable to the leaders and editors of medical 
opinion at this juncture, I shall be ready to amend the 
result of my own investigation, finding it somewhat 
incredible as it stands. The conclusion, as it stands, 
comes to this : that the same effects of smallpox inocu- 
lation which were counted good enough when the object 
was to give protection to their patients from the sub- 



14^ 



THE VARIOLOUS TEST. 



sequent risk of contagious smallpox, were reckoned as] 
nothing at all when the object was to test whether their 
patients had been made safe by cowpox. I do not 
know any uglier incident in the history of medic 
than that astounding volte-face. i 

We have now brought the evidence in favour of the | 
variolous test down through several degrees. Firstly, 
the test, as applied naturally or accidentally at Wood- 
ville's hospital, broke down palpably ; secondly, in a 
number of the early trials for which we have full par- 
ticulars, it was followed by a fair average amount of 
smallpox as inoculated ; thirdly, in the ordinary run of 
cases, it was often followed fay about as much of small- 
pox as the bogus inoculation practice of the time was 
calculated to produce. But if there be still a margin 
of abortive inoculated smallpox standing at the credit 
of the previous cowpox, there is ample explanation of 
the fact without assuming any specific antagonism in 
the vaccine. This is the last remaining point to be 
considered in connection with the variolous test. 

In the first place, for the ordinary purpose of inocula- 
tion, it was not enough to take a child and merely insert 
the smallpox matter under the skin. Some trouble had 
to be taken so as to ensure that the inoculation would 
produce any result at all. We find this frankly admitted 
by an enthusiastic vaccinator, Trotter, the well-known , 
author of Medicina Nautica : ^ — 

'■When my practice formerly lay much in this way, ' 
and finding my incisions often fail in communicating 1 
the variolous infection, particularly with very young ] 



children, I was in the habit of ordering the arm to be 
•weli batlud with warm milk and ivater ; which, when 
wiped with a rough towel, would excite such a temporary 
inflammation of the spot that I never failed afterwards." 
Success in variolation, he concludes, depended, for one 
thing, upon the state of the skin at the seat of puncture. 
As a practical comment upon this, it may be stated that 
Sutton and others frequently succeeded in smailpoxing 
the vaccinated, after the believers in cowpox protection 
had failed.^ 

Jenner himself, in the section of the Inquiry where he 
specifies the sorts of persons for whom cowpox was best 
suited, mentions a class of children who were apt to 
resist the inoculation of smallpox altogether. Scrofu- 
lous children, with clogged absorbent glands, were of 
that kind ; and his own show case, James Phipps, was a 
good instance. A large proportion of the variolous 
tests, especially abroad, were done upon the inmates of 
orphanages and foundling hospitals, who are notoriously 
subject to chronic swelling of the lymphatic glands. 

But the most obvious consideration, which should 
have been familiar to those who first tried cowpox and 
tested it, was that the vaccine infection itself caused a 
swelling and obstruction of the absorbent glands in the 
armpit and neck, and to that extent made them incap- 
able for the time, and in some cases for long after, of 
taking up and passing into the lymphatic circulation 
another virus inoculated under the skin at the same 
place. It was in Paris that this point was chiefly urged 

' See Moseley's Coiiiinenta'ks on the Lues Bo-uilla. London, 
1807. 



■ IJO THE VARIOLOUS TEST. 

by the critics of the variolous test, and the point was at 
length conceded. In England, it does not appear that 
the early vaccinators gave any heed to it. 

Apart from the swollen and clogged state of the 
absorbent glands after cowpox, the mere presence of a 
sore of any kind on the arm served to divert and obviate 
the full action of a new infection. It was a common 
remark, in the earlier period of inoculation with the 
smallpox, that the insertion of the matter by a large 
and deep wound, which suppurated, and either became 
an issue or was made one, tended to keep back the 
general eruption. According to Burges, not a single 
pustule might appear "where the sores keep open" 
and again, "the extent and duration of the primary 
variolous insertion would seem to have checked the 
general eruption." The same experience is stated by 
Ruston in an inverted form, which shows that he did 
not understand the significance of it: "We sometimes 
find the wounds even of those who have afterwards very 
few smallpox, except just in those parts [i.e., around the 
wound], exceedingly foul and very ill-conditioned." 
It is difficult to understand why the original incision 
should have ever been deliberately encouraged to be- 
come a rendering sore, unless it had, as a matter of fact, 
helped to abrogate the eruption, the fanciful theory of 
the time being that such an issue was an outlet for the 
infectious matter pervading the system. 

Now, the cowpox upon the arm was often such a 
discharging sore in the early practice. Most of Jenner's 
original inoculations resulted in eschars and sores that 



DISTURBING EFFECT OF SORES. 151 

went on for weeks, and some of them resulted in quite 
larg;e phagedenic ulcerations. Cline, who made the 
first trial of cowpox in London, actually intended to 
turn the resulting sore into an issue for the benefit of 
the chronic hip-disease of the child on whom the experi- 
ment was tried. In the Stroud experiment with matter 
from the same source (Stonehouse), which produced 
Jenner's cases of phagedenic ulceration, we have a 
striking proof by the method of difference : in the three 
cases which had mild and non-ulcerative cowpox, the 
variolous test at the eighth day gave both the local 
pustule and the ordinary fever with eruption, or, as the 
narrative says, the patients "went through the smallpox 
in the usual way" ; in the other two cases, which had 
severe initial cowpox and open sores for weeks after, 
the variolous test at the eighth day gave the local pustuje 
only, and when it was repeated after the cowpox 
vesicles had actually become eschars or ulcers, it gave 
nothing at all. Such eschars and ulcerations in the 
early practice were not uncommon, being the natural 
effects of cowpox matter in the early removes from the 
cow.' Thus in the series published by Addington, of 
West Bromwich,^ there were ulcerations among his first 
eleven cases, but none in the remaining fifty ; and the 
same event occurred uniformly in the establishment of 
new stocks of lymph from the cow by such experimen- 
ters as Estlin, Bousquet, and Ceely forty years after. 
Now, these first vaccinations were just the cases upon 

' Henry Hicks (of Eastington), Observations on Dr. Pearson's 
" Excanination nfthe Report." Siroud, 1803, p. 43. 

" Practical Observations on the Inoculation of the Cowpox. 
Birmingham, 1801, 



n^ 



THE VARIOLOUS TEST. 



which the variolous test was systematically tried in 
Jenner's timej after it had been tried upon a few cases 
at the outset, with an apparently satisfactory result, it 
was tried more intermittently on those that followed, 
and it soon ceased to be tried at all. Thus the early 
cases had often a condition of the arm or arms which 
sufficed, according to analogy, to render the variolous 
infection nugatory, apart from anything specifically 
antagonistic in the nature of the sore arm. 

In order to bring out all that is here asserted, let us 
imagine a parallel case. Let us suppose that the glowing 
end of a cigar is firmly applied to an infant's arm ; an 
eschar and an indurated sore will result, which may be 
called cigar-pox.^ Let the variolous test be now tried, 
and there is every reason to expect, assuming the 
lymphatic glands to be touched, that the result will be 
the same as after cowpox. Of course the experiment 
can never be made ; but the cigar-pox is in its pathology 
just as relevant to the smallpox as cowpox is. 

Two other things in cowpox infection, besides the 
state of the lymphatic glands and the sore, helped to 
check or render abortive the evolution of the inoculated 
smallpox. One of these was the extent of the areola 
and the degree of constitutional upset ; the other was 
the occasional presence of the general vaccinal exanthem, 
or eruption proper to cowpox. In the series of cases by 
Ward, of Manchester (see p. 130), the only one which did 
stand the variolous test after cowpox was a case in 

' This artifice is actually practised with success by Belgian 
soldiers undergoing imprisonment, so as to get themselves placed 
on the sick-list for venereal disease. See De BroSn, Gas. t/es 
HSpil., 14 Aug., 1880. 



INTERFERED WITH BY ERUPTIONS. IjJ 

which the areola began on the eleventh day, became 
"very extensive" and was accompanied by "much 
fever," the test having been applied on the twenty-ninth 
day. An illness such as that, in an infant of sixteen 
months, would hardly have ceased of its effects in 
eighteen days ; the system would have been sul^ciently 
preoccupied to make the evolution of a new virus im- 
probable. That is a very common type of case ; and it 
exemplifies one of the most obvious reasons why the 
variolous test produced either no smallpox at all or a 
degree less of smallpox than the variolation of the time 
produced in ordinary. 

The vaccinal exanthem or skin-eruption proper to 
cowpox was a frequent incident of the early days of 
vaccination, as it was afterwards found to be in Estlin's 
experience with matter in the first removes from the 
cow.i In Woodville's cases at the Inoculation Hospital 
it got mixed up with the true pustular eruption of small- 
pox which many of the patients had, and the signifi- 
cance of it was not made out for a time owing to that 
confusion. But it was often observed in the country 
practice of vaccination, where concurrent smallpox was 
out of the question. Thus, of seventy cases vaccinated 
by Evans, of Ketley, near Shiffnal commercing in May, 
1799, no fewer than thirty-nine had an eruption.^ Evans 
applied the variolous test in twelve cases only of his 
series of seventy, which had doubtless included a pro- 
portion of the eruption cases. In one of the first 
German trials, at Bremen, a third part of the cases had 



' Land. Med. Gazette, xxii. (183S), p. 977 ; 
' Med. and Phys. Journ.^ ii. 310. 



1S4 



THE VARIOLOUS TEST. 



a rash or eruption.^ Now, an eruption after cowpox has 
the same significance as an eruption after the pox 
proper ; it is a secondary, or a sign that the constitution 
has been touched by the infection, A person still under 
the influence of the secondaries of cowpox would not be 
a likely subject for smallpox engrafted on the top of ft. 
But even if we attach no constitutional significance to 
the proper eruption of cowpox, the mere presence on 
the skin of spots or pimples or vesicles or blebs would 
hinder the full evolution of smallpox by inoculation. In 
the essay by Burges on the Preparation and Manage- 
ment necessary to Inoculation we read that " cutaneous 
eruptions render a child an improper subject for inocu- 
lation until those disorders are removed," That meant 
that the inoculation would either not take at all, or 
would miscarry ; and in the time of Burges, they did 
not wish it to miscarry. It is hardly necessary to 
accumulate evidence on the point. The presence of 
any common eruption, even itch, was well known to 
prevent the cowpox itself from taking. Jenner began, 
about the year 1804, to explain the failure of cowpox 
by an ambitious doctrine of " herpes," which the pro- 
fession gave no heed to ; but it had this grain of truth 
in it, that an infection inserted under the skin would not 
have a fair chance of being absorbed if the skin were 
already engaged with an eruption even of the roost 
ordinary kind. In so far as that was a plea for the 
failure of cowpox, it was a plea for the failure of inocu- 
lated smallpox. Only in those enthusiastic days the 
homely maxim of "sauce for the goose, sauce for the 
gander," was unhappily lost sight of. 



L 



' Hufeland'sybar^a/, xiv. pt. i. p. 66, 



b 




CHAPTER VII. 
THE FIRST APOLOGIES FOR FAILURE. 

WHEN vaccination was passing through a storm of 
adverse criticism during the smallpox epidemic 
of 1805, Jenner wrote to one of his friends,^ that nothing 
of that kind ever shook his faith in cowpoxing. "And 
why ? I placed it on a rock, where I knew it would be 
unmoveable, before I invited the public to look at it." 
The metaphor is too pure to express the whole com- 
plex truth. Jenner placed his doctrine on a rock in 
one sense, and on a shifting sand in another ; and its 
security was just because it was on a mobile basis. That 
foundation was laid, as he correctly states, before he 
invited the public to look at his invention. 

The apologetics of vaccination began in the mind of 
Jenner before his project was given to the world. The 
years of patient observing and proving, which have been 
the subject of so much rhetorical nonsense on the part 
of so many otherwise sane persons, were really a few 
years of indolent casting about by Jenner for the means 
of meeting the obvious objections to the scientific 
whitewashing and professional adoption which he in- 
tended for the vulgar cowpox legend. All Jenner's 



1S6 



THE FIRST APOLOGIES FOR FAILURE. 



medical neighbours knew that there was nothing more 
in the legend than the verbal jingle of cowpox-small- 
pox, just as dog-rose and hound's-tongue were charms 
against mad dogs or remedies for their bites. The 
alleged immunity of poxed milkers from smallpox they 
knew to be a mere popular delusion, which did not 
find the smallest justification in the experience of any 
medical man who had seen much practice among the 
class of milkers. That was the common-sense obstacle 
to Jenner's fanciful ambition to see cowpox inoculation 
substituted for the ordinary inoculation of the time. 
Jenner resolved to circumvent that obstacle, and all 
other obstacles of the evidential sort, by calmly assert- 
ing that the ordinary spontaneous cowpox was spurious, 
and that the sort of cowpox wliich alone gave immunity 
from smallpox was a derivative of horse-grease. 

It is not easy to make out at what period of his 
"researches " Jenner called in the aid of horse-grease. 
The Inquiry, as published in 1798, was pervaded by 
horse-grease everywhere, but it is improbable that the 
equine source of true cow's pox had figured to the same 
extent in the paper when it was sent to the Royal 
Society some eighteen months before. At all events, 
the only experiment that Jenner included in the first 
edition of his paper had been made from a milkmaid, who 
had caught the pox from cows, which cows had been 
infected from a cow (with " overstocked " udder) bought 
at a fair, which circumstance was claimed afterwards by 
Jenner himself, although not with reference to his own 
first case, to be one of the common occasions of genera- 
ting spontaneous or spurious cowpox. He could hardly 
have failed to see that Sarah Nelmes, and consequently 



CHANGE OF GROUVD, IfC> 

which had been the only kind known until Jcnncr 
suddenly denounced it as spurious, and has been the 
genuine cowpox of Ceely^ and all other modem 
authorities. Clearly, then, Jenner*s original distinction 
between spurious and genuine could not be maintained ; 
otherwise he would himself be open to the charge of 
using spurious cowpox, inasmuch as he was using matter 
given him by Woodville, having none other to use. 

Jenner*s next appearance in print was in April, 1799, 
when he came to London and published his Further 
Observations. Spurious cowpox is the grand theme of 
the second essay ; but the doctrine of spuriousness b no 
longer the simple major premiss of •* all non-horse-grease 
cowpox is spurious." Indeed, any one reading Jennet's 
newest publication rather carelessly, and without having 
read the Inquiry y would not unnaturally suppose that 
horse-grease was itself a source of spurious cowpox. He 
gives "the sources of a spurioxts cowpox** as four in 
number : — 

1. Pustules on the oWs nipples or u^ider, which 
pustles contain no specific virus, 

2. Matter which had orij^nally possessed the %r^xX^^, 
virus, but had suffered decomposition either fr^>m y\fx^^ 
faction or from some other cause \t$^ rjc^rxj(^ v, ^\\^, 
senses. 

3. Matter taken from an ulcer Jn aift it^.-r^rxM ^r^t^i^ 
which ulcer had arisen from a true c/J^v-y/'^K, 

4. Matter prodactd otk the human. tWin /rv/y^ y/y/>'^ 
peculiar morbid maiier gemraUd ^// a h//r'y4 

Now, a c^At^% ftitAtf//ff ofte ^4 *h//v. i^.^v^.>f% »''**'/ '^^^/ 



• %tft NiUurat UM&ry ^ ^j&w^)^,y ^ 



ISS THE FIRST APOLOGIES FOR FAILURE. 

do SO. Woodville had, in fact, warned him, before the I 
Inquiry went to press, to cut out everything in it relating 
to horse-grease,' no doubt for the reason which Pearson 
afterwards gave, that " the very name of Horse-grease 
was hke to have wrecked the whole concern," But 
these ingenuous Londoners did not know how essential 
the horse-grease doctrine of cowpox was in Jenner's 
private calculations. One of his veterinary critics saw 
clearly that it was a factitious doctrine, and concluded 
that Jenner had adopted it " rather out of compliance 
with the ideas of the people he was obliged to consult, 
than as the result of his own mature reflection."^ But it 
was against the wishes of others that he retained it, in all 
the prominence that he had given to it, as the stamp 
and seal of the genuine form ; it was "of the greatest 
consequence to point it out here, lest the want of dis- 
crimination should occasion an idea of security from the 
infection of the smallpox which might prove delusive." 
And therewith began the long chapter of vaccination 
apologetics. 

The course of events soon bowled over Jenner's poor 
strategic plea that all genuine cowpox came from horse- 
grease. Woodville supplied the world with vaccine 
after Jenner had failed to do so ; and not only did 
Woodville and Pearson disclaim the horse-grease 
doctrine, but it was quite out of the question that the 
outbreak at the cowhouse in Gray's Inn Lane, whence 
they got their vaccine, should have had such an origin. 
Their cowpox was the ordinary " spontaneous " cowpox, 

' Fraser, Med. and Phys. Joum., 1805, p. 10, 
■ Lawrence, Med. aitd Phys. Journ., i. 115. 



CHANGE OF GROUND. 159 

which had been the only kind known until Jenner 
suddenly denounced it as spurious, and has been the 
genuine cowpox of Ceely^ and all other modern 
authorities. Clearly, then, Jenner's original distinction 
I between spurious and genuine could not be maintained ; 
otherwise he would himself be open to the charge of 
using spurious cowpox, inasmuch as he was using matter 
given him by Woodville, having none other to use. 

Jenner's next appearance in print was in April, 1799, 
when he came to London and published his Further 
Observations. Spurious cowpox is the grand theme of 
the second essay; but the doctrine of spuriousness is no 
longer the simple major premiss of "all non-horse-greasc 
cowpox is spurious," Indeed, any one reading Jenner's 
newest publication rather carelessly, and without having 
read the hiquiry, would not unnaturally suppose that 
horse-grease was itself a source of spurious cowpox. He 
gives " the sources of a spurious cowpox " as four in 
number : — 

1. Pustules on the cow's nipples or udder, which 
pu sties contain no specific virus, 

2. Matter which had originally possessed the specific 
virus, but had suffered decomposition either from putre- 
faction or from some other cause less obvious to the 
senses. 

3. Matter taken from an ulcer in an advanced stage, 
which ulcer had arisen from a true cow-pock. 

4. Matter produced on the human skin from st/me 
peculiar morbid matter generated by a Iwrse. 

Now, a careless reader, or one of those readers wbobdtc 

' See Natural History 0/ Co'Wpox, p. to. 



i6o 



THE FIRST APOLOGIES FOR FAILURE. 



^ 



their impressions from glancing over the leaves, might 
easily go away thinking that No. 4 was the obnoxious 
horse-grease itself. It is difficult to say what the fourth 
source of a spurious cowpox really was ; most probably 
it was horse-grease which had not undergone the mystical 
modi6cation by being grafted on a cow. At a later 
part of the essay, jenner touches on the objections to 
his horse-grease doctrine of genuine cowpox. He does 
not now fight strenuously for it, although he fights more 
strenuously than he had ever done for the radical 
separation of genuine cowpox from spurious. But while 
he insists upon a genuine cowpox, he forgets to say 
what it is, or how it is defined. He hints that he might 
have been mistaken in deducing cowpox from horse- 
grease ; he is willing to consider all the objections that 
had been taken to his hypothesis ; he will merely repeat 
there the six considerations that had weighed with his 
scientific and candid intellect in giving horse-grease the 
prominent position in the doctrine of cowpox which it 
occupied in the Inquiry. In tlie third pamphlet, Con- 
tinuation of Facts and Observatio?is, which came out 
eight months later (December, 1799), horse-grease is not 
once mentioned ; and in the short historical sketch 
which Jenner drew up, of the dawning, development, 
and perfecting of the great vaccination idea in his mind 
during years of quiet and fruitful work in the peaceful 
retirement of Berkeley {On the Origin of the Vacci?ie 
Inoculation, 1801), there is not one word said about 
horse-grease. The thousands who took their ideas from 
that manifesto, or from the exact repetition of it in the 
form of evidence before the Parliamentary Committee of 
1S02, would never have believed that horse-grease 1 



FOLLOWERS LEFT IN THE LURCH. l6l 

the original corner-stone of the whole project and 
doctrine of cowpoxing. The truth is, that the notion of 
"genuineness " and " spuriousness," which was all that 
he ever wanted to establish through horse-grease, was 
soon able to run on its own legs without support 
from pathology or from anything else. " Spurious " 
became a cry ; and, as a cry, it could be used with far 
more freedom and far more effectiveness if it were un- 
committed to definitions, which, as Jenner's old master, 
John Hunter, has said, are, " of all things on the face of 
the earth, the most cursed." 

But while Jenner himself dropped horse-grease, a 
number of persons, who were simple enough to take his 
magnum opus seriously, spared no pains to show that 
the horse-grease doctrine was right.' These partisans 
were more Jennerian than Jenner himself; and one can 
only guess at their queer state of mind when they found 
their hero telling the story of his many years of patient 
and laborious research, and saying not one word about 
horse-grease from first to last This story, which is the 
principal epitome and canonical writing, as it were, of 
vaccination apology, will now be given. 

The paper On the Origin of the Vaccitie Inoculation 
is dated from Bond Street, the 6th of May, rSoi. 
Jenner was now a great personage, had been presented 
to the King a year before, and at the time of his writing 
was in full career as a lion of London society. It would 
be charitable to assume that vanity had turned his head 

' Sir Christopher Pegge, of Oxford, Land. Med. Rev., v. 76 (Oct. 
10, 1800) ; J, H. Grose, of Winslow, Med. and Phys. Joum., iii. 
294 ; John G. Loy, M.D., of Aislaby, Experiments on the Ongin 
of Ike Cowpox. Whitby, 1801. 



163 THE FIRST APOLOGIES FOR FAILURE. 

and made him untruthful ; at all events, the piece is a 
tissue of lies.^ He professes to give a " concise history" 
of the origin of vaccine inoculation, the conciseness 
being enhanced by a charming naivelJ and heartiness 
of manner. The reader is reminded by many simple 
touches of the long period of anxious thought that 
this admirable man endured until he came before the 
world with his beneficent discovery ; if dates or other 
particular circumstances are seldom given, that is merely 
the writer's artJessness and modesty. 

Jenner's first difficulty, in approaching the great cow- 
pQx-smallpox problem which he afterwards solved to 
his own and the world's satisfaction, was one that might 
well have deterred a better-instructed and more sensible 
man. He found that some cowpoxed milkers had taken 
smallpox, just as if their previous cowpoxing were purely 
irrelevant. In his concise narrative, he would have us 
believe that he knew that very well, of his own know- 
ledge, and candidly admitted it ; it was this that "led 
me to inquire among the medical practitioners, who all 
agreed that cowpox was not to be relied upon as a 
certain preventive of the smallpox." The real sequence 
of events was that Jenner, more imaginative than his 
medical neighbours and colleagues, used to air the 
popular fancy about cowpox-smallpox at their medico- 
convivia! meetings ; whereupon the medical men who 
had experience to guide them would good-naturedly 
produce case after case which showed that the popular 



' The Edinburgh Review (1806, October, p. 35) says that this 
" simple and interesting narrative " is the " best and most authentic ' 
It of his discovery." 



THE HISTOKV AS IT OUGHT TO HAVE BEEN. 163 

belief, in so far as it was held even by the vulgar, was 
a mere verbal illusion ; Jetiner, however, was so per- 
sistent in arguing against the facts that, as he told 
Baron, the members of the Society threatened to expel 
him as a bore.' That was how Jenner came to know 
so well that all cowpoxed milkers had not been pro- 
tected from smallpox. 

For a while, the concise narrative goes on, these ex- 
ceptional cases damped his ardour, but did not extin- 
guish it If we are to believe the story that he had 
occupied his thoughts with this question ever since he 
was a pupil at Sodbury, the statement means that his 
ardour was damped a very long while, something like 
five-and -twenty years. At length he " had the satisfac- 
tion to learn that there were some varieties of sponta- 
neous eruption, all of which produced sores on the 
milkers." Only one of these was the tnie cowpox ; the 
others were spurious, as they possessed no specific power 
over the constitution. Here, then, was the obvious 
explanation of some cowpoxed milkers taking smallpox ; 
their cowpox sores had been spurious. 

Of all the many sly and impudent tales that Jenner 
told to the medical profession and to the public, the 
short sentence just quoted is the most sly and the most 
impudent. He trusted, and rightly trusted, to general 
readers, and even medical editors, having short memo- 
ries. Before we state the real development of doctrine 
about true and spurious cowpox, let us see how this 
concise narrative was received by the principal London 
organ of medical opinion. We are apt, says the editor. 



164 



THE FIRST APOLOGIES FOR FAILURE. 



to forget the throes and travail of a discovery after we" 
have become familiar with the perfected achievement : 
" Who now wonders at the discovery of America, or the J 
Circulation of the Blood ? There is, however, a period 
between the conception of a discovery and its mature 
birth fraught with more pangs than war or women 
know ; and there is no light in which the human mind ' 
can be viewed more interesting than during this anxious ' 
period,"' Rhetorical rubbish, instead of sober criticism. 
The very same editor had reviewed or analysed the 
Inquiry only two years before ; the Inquiry was Jenner's 
magtium opus, his deliberate production, the mature 
birth of his discovery, after "more pangs than war or 
women know"; and the ever-recurring burden of the 
Inquiry is that true cowpox was not a spontaneous 
disease of the cow at all, but an infection derived from 
the horse ; while the spontaneous cowpox is mentioned 
by name in two places, and a third time by implication 
on the last page of the essay, only to be dismissed as 
spurious. And now, in the concise narrative of the 
slow incubation of his ideas and the gradual perfecting 
of his researches, Jenner calmly informs the world that 
he long ago discovered the true cowpox in one of tlie ' 
varieties of the spontaneous malady, while he keeps silence 
about the elaborate doctrine of the Inqtdry of 1798, that 
«// spontaneous cowpox was spurious, and the only true 
cowpox a derived infection from the horse. The audacity 
of this proceeding will show all the more if we recall the 
fact that his second essay, the Further Observations of 
1799, actually reveals the disingenuous workings of his 




MYTHICAL HISTORY. 16$ 

mind in choosing a new ground for the doctrine of 
" spuriousness " under the pressure of his own and other 
failures at Stroud, in December, 1798, of criticism by 
Ingen-housz, of the dislike of horse-grease generally ex- 
pressed, and of his having to adopt Woodvilie's spon- 
taneous cowpox as the " true Jennerian " for want of 
any stock of his own. 

The " concise history " then proceeds : " But that was 
not the worst obstacle and check to my fond and aspir- 
ing hopes." Of course fond and aspiring hopes carry us 
back to the obscurity and discouragement of early days. 
This worst obstacle was that some milkers who had 
been infected even with the true cowpox had caught 
smallpox afterwards. Now in Jenner's classical work, 
in the great Inquiry itself, as well as in the succeeding 
essays, there is not one word said of any milker having 
been infected with true cowpox and afterwards with 
smallpox, even if we allow Jenner to have as many 
definitions of " true " as there are points in the compass. 

What he i.s pleased to describe as the " worst obstacle 
to his fond and aspiring hopes" is so absolutely an in- 
vention to serve a doctrinal apologetic purpose in after 
j-ears, that he cannot adduce a single illustration of 
it among the original cases of cowpoxed milkers upon 
which his theory and project were based. But he knew 
of such cases, all the same, in the days of his fond and 
aspiring hopes ; and they led him to reflect " that the 
operations of Nature are generally uniform, and that it 
was not probable the human constitution (having under- 
gone the cowpox) should in some instances be perfectly 
shielded from the smallpox, and in many others remain 
unprotected. I resumed my labours with redoubled 



1 66 



THE FIRST APOLOGIES FOR FAILURE. 



L 



ardour. The result was fortunate : I now discovered I 
that the virus of cowpox was liable to undergo pro- J 
gressive changes, from the same causes precisely as that J 
of smallpox; and that when it was applied to the I 
human skin in its degenerated state, it would produce I 
the ulcerative effects in as great a degree as when it was 1 
not decomposed, and sometimes far greater; but having I 
lost its specific properties, it was incapable of producing 1 
that change upon the human frame which is requisite I 
to render it unsusceptible of the variolous contagion," I 
This was none other than the main argument of Further \ 
Observations (April, 1799), a pica which he had to I 
trump up in order to answer Ingen-housz and to cover I 
his own ulcerative failure with the Stonehouse cowpox j 
in December, 1798, and the still more awkward, because j 
more notorious, failures of Thornton and Drake, of | 
Stroud, with matter from the same source. 

Having thus carried us over the many years of pre- 
paration and parturient travail, Jenner next brings us, in I 
the concise history, to his first experimental trial of cow- J 
pox, the famous case of James Phipps on 14th May, I 
1796. Again vast labours and mental anxieties interpose I 
(represented, in reality, by the memorable attempt to I 
give a young horse the grease by keeping him in the \ 
stable and feeding him on beans), and we come down to J 
the month of March, 1798, to the case of the child Baker, 
who was horse-greased, and died in the workhouse, and ] 
to the half-dozen or more cases of inoculated cowpox in 
other children. The narrative then proceeds: "Thej 
result of these trials gradually led me into a wide field I 
of experiment, which I went over not only with great I 
attention but with painful solicitude. This became uni- \ 



WOOnVILI.E SAYS NOTHING. 167 

versally known through a treatise published in June, 
1798." 

In so far as any wide field of experiment, subsequent 
to the trials of March and April, 1798, comes into the 
Inquiry published in June, 1798, the above statement 
is the mere coinage of his brain. He hurried off to 
London in April, 1798, with the draft of the Inquiry in 
his pocket, without waiting even to ask the great question 
of his cowpoxed patients, namely, whether they could 
stand the variolous test. If there were any painful 
solicitude made known through the Inquiry, it was the 
solicitude of having to consider the importunity of 
VVoodville, after he had read the manuscript of that 
work, that horse-grease should be entirely cut out from 
the programme,' 

Woodviile was one of the few men in the pro- 
fession who knew almost as much of the secret history 
of Jenner's discovery as we know now; and he could 
easily have shown up the concise narrative for the 
romance which it certainly was. But he was a man of 
quiet disposition, far more inclined to efface himself than 
to enter into a controversy with such a man as Jeniier; 
and he never wrote anything in the vaccination dis- 
cussions beyond a dignified and candid explanation of 
the smallpox eruptions which befell his first vaccinated 
cases at the Inoculation Hospital, and had been diligently 
turned to account by Jenner in order to discredit 
Woodville's share in the discovery. 

The " concise narrative " ends with the publication of 



' H. Fraser, M.D. (Woodville's pupil and successor at the Small- 
pox Hospital), in Med. and J'hys. Joum^ 1805, p. la 



i6S 



THE FIRST APOLOGIES FOR FAILURE. 



the Inquiry ; it says nothing of the Further Observations 
of 1799 — for the sufficient reason that it refers back the 
extemporized argument of that work to the mythical 
period of the discoverer's early wrestlings with his great 
idea. 

The cry of "spurious lymph" was the great excuse 
for the failures of cowpox to protect from smallpox, as 
well as for the ulcerous and other bad effects of that 
infection itself. It is unnecessary to show that the plea 
of " spuriousness " was a transparent piece of sophistry,* 
elastic enough to cover all failures and disasters whatso- 
ever. What we are here concerned with is the way in 
which the profession received this plea, the scrutiny 
and discussion they applied to it in general, and the 
evidence they required for each spurious case as it 
arose. Let us remember that cowpoxing was then a 
new thing on its trial, and that there is always a pre- 
sumption, in the minds of a later generation who take a 
thing on trust, that a new project, especially if it be a 
scientific one, had been thoroughly tested and debated 
on all sides before it received the general assent of its 
own age. We have already seen what they made of the 
variolous test ; we have now to inquire into the reception 
which they gave to the apologetic plea of spurious 
cowpox and spurious lymph. 

The first person to bring Jenner to his bearings about 
" spurious " and "genuine" was Dr. Ingen-housz, although 
it was spurious smallpox that Ingen-housz had occasion 

' So far as concerned cowpox in the cow, Jenner was plainly ' 
told in the report of the College of Physicians (1S07), that his 
"spurious" doctrine was one by which "ihe public have been 
misled, as if there were a true and a false cowpox." 



"spurious" improved upox. 169 

to protest against. This episode between Jenner and 
Ingen-housz might well have been forgotten, had it not 
been the first suggestion of Jenner's later doctrine of 
spurious cowpox. In replying to Ingen-liousz, both by 
private letter^ and in identical terms in the Further 
Observations, he not only re-affirms the absurd doctrine 
of smallpox made spurious and ceasing to be smallpox 
from some imaginary putrefactive change, but he has 
the assurance to say that the cowpox in Ingen-housz's 
case of the Wiltshire farmer who had afterwards taken 
smallpox, must have been also spurious owing to the 
same putrefactive change, for it was stated that the 
cows gave out a stench from their ulcerated teats. 
Ingen-housz, as we have remarked in a former chapter, 
saw that his correspondent was either a fool or a knave, 
and took no farther notice of him. But it was his sharp 
rebuke over the spurious-smallpox doctrine that led 
Jenner on to his equally audacious doctrine of cowpox 
made spurious by putrefaction or " some other change 
less obvious to the senses," Jenner does not say that 
the putrid smallpox virus failed to produce an infection 
with the objective characters of smallpox, any more than 
he says that spurious cowpox matter failed to produce 
the correct vesicle and other developments of cowpox. 
He merely says that the disease so induced failed in 
both cases \xi protect from future smallpox. He is guilty 
of so transparent a begging of the question that it is 
really hard to decide whether folly or knavery entered 
most into his excuses. 

The same answer [hat Jenner made to Ingen-housz's 



THE FIRST APOLOGIES FOR FAILURE. 



k. 



case of the Wiltshire farmer was made, on his behal 
the notorious case of Mr. Jacobs, of Bristol, which at 
one time staggered the faith of Dr, Beddoes and of Dr. 
John Sims. That case received far more publicity than 
the case adduced by Ingen-housz, and it was answered 1 
by Jenner's nephew and assistant, Henry Jenner, in an I 
Address to the Public^ a quarto pamphlet of twenty I 
pages, which contains, along with other puerile matter, i 
the following statement of the doctrine of spurious cow- 
pox: — 

" Every case that has been brought forward to under- 
mine the theory we defend, we can prove to a demon- 
stration was not one of the gemiine kind. There are 
three diseases called cowpox, only one being genuine. | 
Animals exposed for sale acquire inflammation of the J 
udder, which terminates in eruptions on the teats and I 
udder and affects the milkers with a loathsome disease \ 
on the hands, arms, and shoulders. [The very circum- 
stances in the case of Sarah Nelmes, who supplied James I 
Phipps.] The forehead sometimes does not escape, I 
from the servants leaning against the udder. This I 
disease may affect the same person several times, but it I 
will never prove a preventive for smallpox. A case of l 
this kind occurs in the city of Bristol : a Mr. Jacobs, 
attorney-at-Iaw, was extensively affected /•zvice with this I 
disease (which, from his total ignorance of nW cowpox, , 
he has called by that name), but it did not prevent his I 
being afflicted with a subsequent severe smallpox." 

The public and the profession were vastly impressed I 
with the idea that the Jenner family alone knew what ] 
real cowpox was. Sims had been approached privately 
before this, and had acknowledged that Jenner's nephew j 



FOSBROKE PUT UP TO DEFEND. I?! 

had proved the case of Mr. Jacobs to be spurious. 
Beddoes, who first took up the Jacobs case, was even 
brought to book by Jenner's parson, Fosbroke. The 
cowpox, said this bold cleric,^ which Mr. Jacobs had 
contracted in youth, was undoubtedly spurious : " I 
speak from actual observation [of Jacobs?], Dr. Bed- 
does from description only." The same clerical advo- 
cate had the assurance to reply to the case of the 
Oxford college porter, published by Dr. Hooper, 
physician to the Marylebone Infirmary.^ Fosbroke 
knew that the cowpox which the porter had contracted 
in Wiltshire, five years before he died at Oxford of 
confluent cowpox, was spurious, because Hooper had 
stated that the sores on the hands " were larger than 
those of the smallpox, and ended in a brown crust." 
The clerical proof that this, the correct mark of cowpox, 
indicated the spurious disease, was an indirect one ; 
Fosbroke's own dairymaid had caught cowpox only two 
months before at Mr. Walkeley's farm, whither she had 
been sent to learn the art of milking ; in her case also 
the pustules were larger than those of smallpox, and 
ended in a brown crust. " That I should err in suppos- 
ing this a spurious disease is impossible. My own 
children were at that very period of time infected with 
the tnie cowpox, the inoculated pustule being then in a 
state of complete maturation. The points of difference 
between the two diseases were visible, though unneces- 
sary to be repeated here, as they are clearly described 
in Dr. Jenner's publications." Fosbroke wrote again,' 



' Lotid. Med. Rev., Aug., 1799. ' Ibid., Letler of I2lli July, 1799. 
' Med. andPkys.Joum., iii. (iSoo) p. 249. 



172 



THE FIRST APOLOGIES FOR FAILURE. 



I 
I 



on nth Feb., 1800, and disclosed a fact which he must 
have known at the time of his writing in July : " I have 
mentioned virulence in cowpox. Owing to the neglect 
of advice, my own child had it exceedingly severe," the 
" pustules " requiring to be treated with vitriolic acid ; so 
that the points of difference between the spurious form 
on his dairymaid's hand and the genuine on his child's 
arm were perhaps not so very great, all things con- 
sidered. 

Another member of the family employed to urge the 
"spurious-or-genuine " plea was the Rev. G. C. Jenner, 
of Burbage, Wilts, He wrote a paper ^ on Spurious 
Vaccine, "with an ardent wish that my remarks may 
throw a ray of light on a subject which so intimately 
concerns the dearest interests of humanity." In two 
instances he had seen the perfect and the spurious cow- 
pox co-existing in the same person, for which strange 
thing he did not presume to assign a cause. He had 
vaccinated himself fifty times before he produced any 
result, and when he did succeed at the fiftieth time, the 
vesicle was spurious. It was by pricking the back of 
his hand with a lancet, in order to show a young lady 
of timid disposition how simple the operation was, that 
he eventually raised the genuine cowpox vesicle, After 
these curate-like experiences, he comes to the larger 
view of the question, which so intimately concerned the 
dearest interests of humanity : — 

" From whatever source the spurious pustule may 
arise, there is this satisfaction, that it is very easily 
distinguished from the perfect disease by those who 



DEFINITION OF "SPURIOUS" PROMISED. 173 

have paid any attention to the vaccine practice. The 
features of the genuine disease are strongly marked, 
and require but little discernment to be familiarly ac- 
quainted with them." 

The medical profession, however, were not quite so 
clear about the differences between genuine and 
spurious, having less discernment than this reverend 
cowpoxer. In the summer of 1801 the editor of the 
Medical and Physical Journal^ intimated that "ingenious 
artists are now at work, in the hope of being able to 
give accurate representations of the true and spurious 
pustules." In a later number, Dr. Stokes, of Chester- 
field, wrote ^ that he was glad to hear of the artists 
being at work, for such pictures were much needed ; 
there were two forms of inoculated cowpox, the vacciola 
scutellata and the vacciola leprosa, and it was not easy 
to distinguish them ; nine persons at Chesterfield had 
taken smallpox after being vaccinated with vacciola 
leprosa, and two of them had died. In the beginning 
of 1802 the editor of the Medical and Physical Journal 
again writes:^ "We cannot help regretting on this 
occasion that Dr. Jenner's engagements prevent him 
from giving to the public those very accurate and 
beautifully coloured plates which he is now preparing 
to accompany the next edition of his works. Those 
plates would indeed be a rudder and a compass by 
which the practitioner might steer with safety." 

Whether the plates of spurious and genuine cowpox 




i;4 



THE FIRST APOLOGIES FOR FAILURE, 



really were very accurate and very beautiful, there was 
never any means of j udging ; they were never published, 
nor did the projected new edition of Jenner's works on 
vaccination ever see the light, The profession went 
drifting on without the rudder and compass which 
the sapient editor thought these plates would have 
supplied them with. The rudder and compass which 
the profession really needed were the rudder of patho- 
logical principles and the compass of rigidly scrutinized 
facts ; these together would have guided them to the 
conclusion that the project for exterminating smallpox 
by means of cowpox was an imposture on Jenner's 
part and an illusion on theirs. 

The use made of the plea of "spurious" to stop all 
free inquiry into the merits of Jenner's claims is illus- 
trated in the medical journals of the period. Thus Dr. 
John Fawssett, of Horncastle, Lincolnshire, sends to 
the Medical Journal^ three cases of children who took 
smallpox after being vaccinated ; whereupon the editor, 
in the exercise of his privilege, designates the cases 
"spurious" in the headlines and title. The same liberty 
is taken with cases immediately following, by Dr. John 
Stevenson, of Kegworth, Leicestershire. In a subse- 
quent number,- Stevenson remonstrated, under date 
17th November, 1801 : — 

" May I be permitted to solicit your reasons for de- 
nominating viy cases of cowpox, as related in a former 
number, spurious f" He then offers some "cursory 
observations" on the vague use of the epithet "spurious 



EXALTED AND RESPECTABLE NAMES. 175 

or imitative, as expressive of a deceptive species of 
cowpox, and on tlie absolute want of its diagnosis," 
Stevenson writes like a scholar and a practised logician ; 
his masterly criticism of the loose usage of the Jennerians 
and their high-placed abettors ought to have opened the 
eyes of the profession to the illusions that were being 
practised with names, only that the profession unfortun- 
ately had no great wish to have its eyes opened. 

Two instances of this prevailing temper will serve to 
show how irretrievably the long career of apologies 
had been entered upon. Dr. Denman, who had come 
forward to give cowpoxing his weighty support in 
March, 1800, wrote another letter in June following:^ 
"Since that time," he says, "there have been many 
vague reports of cases, in which it was asserted that 
several persons who had been inoculated for the cowpox 
had afterwards been actually infected with the smallpox. 
Presuming that some error in the nature of the matter 
inoculated, or in the conduct of the operation, must 
have been the cause of such opposite conclusions (if 
there was any foundation for the reports)," he begs to 
send for publication a letter from the Eari of Derby 
intimating the successful vaccination of two of his lord- 
ship's own children. Denman knew well that, in a 
country like England, these two infant Stanleys were 
the very best form that logic could take ; and in the 
same number of the Journal the editor triumphantly 
refers a sceptical Newcastle correspondent to the " ex- 
alted and respectable names which appear in the first 
pages of this number." The Newcastle Advertiser had 



176 



THE FIRST APOLOGIES FOR FAILUKE. 



published a paragraph against vaccination, which the j 
editor of the London professional organ advises his 
northern colleague to treat after the following analogy : 
" A paragraph or letter very similar appeared a few 
weeks ago in a London paper ; but the Faculty here 
treated it with the silent contempt it merited ; being 
persuaded that the declamatory effusions of such writers, 
when opposed to the opinions of Jenner, WoodviUe, 
Pearson, Denman, Saunders, Cline, Keate, Ring, Knight, 
Abemethy, and many others equally respectable, have j 
no weight with a discerning public." 

The other sample of the professional niood shall be- 1 
taken from an article by Dunning, of Plymouth, in the 
saxae^ Journal for January, 1S02 :— 

"Reports the most fatal to its interests continue daily 
to accumulate, and are circulated with much earnestness, 
and even apparent satisfaction, by at least the sceptical, 
the anile and the foolish, uncontradicted and un- 
checked." There had been misrepresentations at Ply- 
mouth, and these had spread through Cornwall ; they 
had been counteracted, but only for a time, by the 
strong testimonial in the Medical Journal, and by others 
in the Sherborne and Exeter papers, "Let the public 
mind be no longer distracted by the circulation of dread- 
ful accidents and numerous failures [why not ?] which 
are so eagerly caught at, edited, and improved by the 
ignorant and the prejudiced," He then raises the grand 
issue with a preciseness that leaves nothing to be 
desired : " The genuine vaccine lymph does, or does not, 
possess an absolute preventive power against variolous 
contagion. Such power is, or is not, a law of Nature. 
The protection, if it affords protection, cannot be casual. 



DOUBLE USE OF THE "SPURIOUS" CRY. I?/ 

it must be regular and determined." ' Dunning had no 
doubt at all that such protective power "was the law of 
Nature ; if the lymph were genuine, it would protect ; 
whatever lymph failed to protect must have been 
spurious. 

One point remains to be made clear, before we leave 
this doctiine of spuriousness, by which the profession 
deceived themselves or allowed themselves to be de- 
ceived. It had not one great application, but two. In 
the years 1801 and 1802 tlie doctrine was mostly in 
request to explain away failures to protect, or, in other 
words, cases of smallpox caught in the ordinary way by 
tiiose who had been cowpoxed ; for the epidemic was 
then reviving a little from the periodic lull which had 
happened to correspond with the first trial of Jenner's 
nostrum. But in 1799 and rSoo there had been another 
use for the cry of "spurious"; it was then wanted to 
silence the clamour which threatened to arise owing 
to the number of ulcerated arms. These were a very 
common experience, if we may judge from the narra- 
tives of the more candid. Thus, Addington, of West 
Bromwich, one of the first to publish his experiences of 
Woodville's lymph, had five ulcerated arms in his first 
eleven cases.- Evans, of Ketley, near Shiffnal, who was 
supplied by Addington, says:^ "Those few patients 
whose arms were most inflamed were of the first that 
were infected, which I attributed to the cold N.E. winds, 
as they were disposed to become troublesome ulcers." 

■ Med. and Phys. Joum., vii. 3. 

' Practical Observations on the Inoculation of the Coivpox. 
Birmingham, 1801. 

" Med, and Phys. Jeurn., ii. 310. 



I7S 



THE FIRST APOLOGIES FOR FAILURE. 



Brown, of Hatton Garden, wrote to the Gentleman'i 
Magazine (May, 1800, p. 433J, that " nasty, ugly, and iiu 
veterate ulcers have remained in the arm long after-fl 
Stromeyer, of Hanover, one of the first to try the nem 
inoculation on the continent, got matter from Woodvilld 
and apparently also from Jenner ; "The Gloucestd 
matter frequently occasioned ulcerations of the inocu^J 
lated parts of a tedious and lonj; duration, which the^l 
former matter never did."^ He had therefore given upM 
Jenner's stock, which was, after all, only Woodville'sS 
altered for the worse in character in a series of trans^j 
missions. Wilke, of Brandenburg-an-der-Havel, hat 
numerous cases of ulcers with elevated edges and i 
bacon-like floor, sometimes larger than a half-thalei 
piece." Cappe, of York,^ admitted that "in some in- 
stances the crust separates and leaves a spot unhealed 
like that of an issue. In some of the earlier inocula* 
tions, these sore places became troublesome, but at th^ 
time the proper treatment was not discovered." 

The most famous scries of ulcerated cowpox i 
happened among a rather poor and querulous set 
people in Thunderbolt Alley, Clapham, in the fall of thi 
year iSoo;'^ the parents of the poxed children weii 
"much prejudiced, full of invective, and refused to coia 
verse reasonably." The lymph was of correct pedigrw 
and had been taken from the arm of a gentlemait'J 



' Letter of 14th March, 1800, mM^ii. and Phys. Joum., Londol 
iii. 474 ; also Hujeland's Journal, x. pt. 3, p. 106. 
' Med. Chirurg. Zeitung, iSoi, ii. 424. 

* Med. and Phyi. Joum., iv. 434. See also Ibid., v. 25 (letter II 
York Herald). 

* Lond. Mid. Rev., iSoi (Jan.), p. 276. 



NOT COWPOX, BUT ULCERATION. 179 

child ; only it had been taken after the crust began to 
fnrm on the vesicle, and it therefore represented a late 
type or a full cycle of cowpox, coming near to that of 
cowpox on the cow herself or on the milker. The effects 
were erysipelas, rapidly spreading ulceration, and slough- 
ing ; a woman, aged thirty-five, had a large, irregular, 
oval sore, with elevated edges of a livid colour. We 
now Itnow that such effects can be produced at will by 
systematically using lymph from a late period of the 
pox, or, in other words, by using the infective matter 
in a state fully representative of the cow's ulcerous 
affection. 

But let us observe how such an untoward incident 
was explained away, Blair, the editor of the Medical 
Review, said that it arose from "this spurious sort, or 
from a violent matter derived from the cow." Dr. 
Lettsom, a leading physician, and a fussy or influential 
person among the charitable, rushed to the help of the 
endangered cowpox project with a letter' dated 35th 
November, 1800 : ■' The disease," he assured the public, 
"was not cowpock, but morbid ulceration, originating 
from the purulent matter formed under the scab or dried 
pustule of the cowpoclc." Lettsom, whose writings prove 
him to have been something of a windbag, did not know 
what he was talking about.- If the subject had been a 
suitable one for conundrums, Lettsom and such as he 
would have been in their element. When is the cowpox 
not the cowpox P Answer : (i) When it fails to protect 



' Med. and Pkys.Joum.^ iv. 567. 

= Observations on lite Cow-Pock. By John Coakley Lelisoin, 
D , LL.O., 2ad ed. London, 1801. 



THE FIRST APOLOGIES FOR FAILURE. 






from smallpox; {2) When it produces "morbid ulcera 
tion." 

Besides the apologetic plea of spurious lymph, th^ 
excuse was sometimes put forward that the smallpox! 
ensuing was not smallpox but something else. Thus,,! 
Bevan of Stoke-on-Trent sends two cases of childre 
who had been vaccinated on the 12th of JanuaryJ 
because their mother had confluent smallpox, and hadf 
themselves sickened for that disease on the 23rd] 
and 24th respectively, the one having sixty pustules c 
the 28th, and the other, twenty on the 29th, "exactly' 
like smallpox in every respect." To this perfectly^ 
credible recital the editor of the medical journall 
coolly appends a note: "We think this eruption was* 
not variolous."^ The common explanation of an eruptions 
of the milder sort was that it was really chickenpoxT 
even if the circumstances of infection should havef 
suggested smallpox.' At a later period that excuse 
grew into the doctrine of varioloid or " modified " small-j 
pox, especially in connexion with the epidemic in Scot«J 
land in iSiS, described by Thomson.^ In the ViennftJ 
school the same mode of reasoning was carried so falJ 
that varicella, the learned name of chickenpox, actually] 
came to be used as the equivalent of discrete smallpoS^ 
or varioloid, or " modified " smallpox (e.g-., in Hebra'd 
writings), and continued to be so used down to recena 
times,* 



' Meii. and Phys. Joum., v. 455 (nth Feb., iSoi). 
' Forbes, Ibid., vi. 314. 
^ See chapter xiii. 

* In 1S71 the writer had an attack of illness in Vienna, c; 
uhile attending the smallpox wards of the AUgemeine Kmokaf 



MYSTICAL SCIENCE. iSl 

Other and more subtle excuses for failure were made 
in Germany (see chapter ix.) ; but the two stock 
English pleas were, either that the lymph was spurious, 
or that the ensuing disease was not smallpox. The 
nearest approach to the refinements of the Germans 
occurs in a case in which Sir Joseph Banks played a 
part. Being personally interested in a child in the 
country who had caught smallpox six months after 
vaccination, he wrote to the medical attendant, Dr. 
Harrison, of Horncastle, and received the following 
explanation : The child had been vaccinated success- 
fully, and others in the house had in turn been vacci- 
nated from her. Now these latter did not take smallpox 
on the occasion when their vaccinifer did, although they 
were in the same house ; "hence it appears that Fanny 
communicated a security against the smallpox to 
others, although she herself remained liable to its 
influence." With this mystical reasoning the good 
president of the Royal Society would appear to have 
been well content, for he allowed the letter which his 
inquiry had elicited to be published In the Medical 
Journal} 

Such, then, was the programme of excuses which 
came to be generally adopted for the failure of cowpox. 



haus. The late Professor Skoda, who made the diagnosis during 
the eruptive fever and when the eruption was appearing, used the 
puzzling term "varicella," which, to an English student, had no 
other meaning than chickenpox. The eruption developed into the 
ordinary pustules of smallpox and ran the ordinary course, The 
diagnosis was so made, doubtless, on account of the e; 
obvious vaccinal mark on the arm. 
' Med. and Phys. Jount., v. (1801), p. 108. 



1 82 THE FIRST APOLOGIES FOR FAILURE. 

As Jenner said, he had placed it on a rock before he 
invited the public to look at it The patient thought, 
etc., which he gave to the subject before he wrote on it 
was merely to invent the plea of " spurious." That plea 
occupied a great part of the Inquiry, in connexion with 
the horse-grease doctrine of genuine cowpox ; and it 
occupied the whole of the Further Observations, in con- 
nexion with an entirely new and hitherto unheard-of 
doctrine of what was genuine and what was not. As he 
employed some of his following to give plausibility to 
his invented name of "smallpox of the cow," so he 
employed others of them to spread abroad the doctrine 
of spuriousness. In both matters he found the pro- 
fession only too willing to be deceived. With the very 
first trials of cojvpox begins the long course of hard 
swearing in defence of a radically mistaken and 
erroneous doctrine, which the medical profession has 
been able to pass off for expert testimony, on the 
strength of the excellent maxim, Ciiique in arte sud 
credendum est. We have next to see how deeply the 
English profession was committed, by its leaders, to 
Jenner and his doctrines within the first year, or the 
first two years, of the novelty being tried. 



CHAPTER Vin. 

GENERAL ASSENT IN ENGLAND. 

WE have thus far seen what kind of evidence the 
profession had before them, on the protective 
power of cowpox, and what kind of apologies they were 
prepared to make for failures and disasters. They never 
went deep enough into the anatomy and pathology to 
realize what sort of pox the cowpox actually was, and 
they had none of the milkers' experience to teach them 
in the most forcible of all ways. Their behaviour over 
the variolous test was incredibly stupid and careless. 
Their chief apologetic plea of spuriousness was wholly 
alien to the spirit of logical investigation, and a flagrant 
example of the art of circumventing the unwelcome 
teachings of experience. 

It is hard to believe that the many educated and 
conscientious men, who belonged to the medical profes- 
sion of Britain in those years, had given their reasoned 
assent to a doctrine and practice so full of frauds and 
fallacies that a later generation will hardly bear to have 
the naked facts exhibited to the public gaze. 

It is by no means certain that the active spirits in the 
new project were either many, or fairly representative of 
the best professional qualities. The evidence of Dr. 



GENERAL ASSENT IN ENGLAND. 



Moseley, an opponent, may be thought tainted in regard | 
to the quality of the early backers of Jenner ; but, if we 
allow for his love of stating a case in a few hyperbolic 
strokes, his testimony is not without its value and sig- 
nificance. Writing in i8o8, he said : ' " The mere opera- j 
tive practice of vaccination has been chiefly carried on 
by lady-doctors, wrong-headed clergymen, needy and | 
dependent medicasters, and disorderly men-midwives. 
No man of letters, or of the least pretensions to s 
Dr. Pearson excepted, has lately been concerned i 
It has been, and now is, in the hands of the most j 
ignorant of medicine," That is Moseley's exaggerated i 
way, which has always caused large deductions to be .1 
made from his credit. 

Vaccination, very likely, was most affected by the class I 
of amateurs and fussy novelty-hunters to whom he | 
refers ;but it was tried and countenanced quite early in i 
the day by a certain number, perhaps not a large ( 
number, who were by no means among the ignorant I 
of the profession. It is true that some second or third- 
rate persons, such as Ring, Huggan, and members of j 
the Jenner family, do come up again and again in tlie [ 
vaccination writings of the time, like the stage-army, 
which makes a great parade by going off at one wing ' 
and on again at the other ; but there were some distin- i 
guished names among its early patrons, without whose, 
support the new doctrine and practice would hardly I 
have made way. 

It is even more important, for understanding how 1 



I 



A Review of ike Report of the Royal CoHege of Physicians o: 
Vaccirtation. London, iSoS, p. ii. 



CRITICISM SILENCED BY ABUSE. }S$ 

general assent was secured, to observe the nature of 
the opposition, Moseley was the only considerable 
person who put his foot down at the outset (September, 
i^gfl), while it was still possible to have killed the im- 
posture by criticism. When Woodville's activity set 
men talking, several more made a feeble show of hesita- 
- tion, or called attention to the evidence against Jenner's 
■ theories. Of such was the eminently respectable Dr. 
John Sims, who was speedily denounced by Jenner as a 
"snarling fellow," and thereby brought to his proper 
bearings within the next month or two. The charges of 
jealousy, malignity, and the like were so freely flung 
about on speculation by the personal following of Jenner 
that it needed some strength of conviction, as well as 
an established reputation, to remain indifferent to them. 
None but the staunch conservatives of the old inoculation 
continued to make a firm stand ; and although many 
medical men must have withheld their assent for a long 
period, and some even for their whole lives, yet, like the 
corresponding large class of solid and sensible, if some- 
what apathetic, men in the profession who watch the 
successive crazes of our own day, they would make 
hardly any show in the public controversy, leaving the 
novelty to be judged by time. 

The practical success of Woodville in procuring an 
abundance of cowpox matter for trial, and the con- 
firmation, under the eyes of a number of men in London, 
of the correctness of Jenner's plates and of whatever 
objective description his text contained, gave a start 
to the movement which would have else been wanting 
perhaps for ever. Kven the authoritative voice of the 
Royal Society, in the person of Sir Joseph Banks, the 



1 86 



GENERAL ASSENT IN ENGLAND. 



^ 



president, was turned from its former opposition to a 
more or less cordial assent, after the demonstration of I 
cowpox at the milk-farm in Gray's Inn Lane. Sir | 
Joseph was not the man to oppose anything, if it seemed 
likely to become a success. Mr. Cline's interest had 
been enlisted from the first appearance of Jcnner in 
London. Mr. Abernethy had sent for publication some 
observations on cowpoxed milkers collected by his 
brother-in-law, the Rev. R. Holt, of Finmere, Oxford- 
shire, and had so been drawn into the circle of Jenner's 
supporters. Mr. Francis Knight, a court surgeon of 
great influence, who was connected with the west country, 
had heard of cowpox before, and was ready to back up 
the Gloucestershire project as in private duty bound. 
Dr. Denmari had been button-holed about it, and gave 
the weight of his name, without showing any intelligent 
grasp of the problem. Dr. Saunders, senior physician 
to Guy's Hospital and a leading man at the College of 
Physicians, had also allowed his name to be used. At 
Oxford, Sir Christopher Pegge, reader of anatomy and 
one of the leading physicians, happened to hear of cow- 
pox and horse-grease in company at a farm near Thame, 
and came forward with his cases as a warm supporter of 
the movement ; although the shifty Jenner was at that 
very time seeking to escape from the horse-grease 
doctrine which poor Sir Christopher's cases proved. At 
Cambridge, Sir Isaac Pennington, regius professor of 
physic, had made inquiries among the dairy farms in the 
Cottenham district ; he had formed an opinion adverse 
to the horse-grease part of the hypothesis, and he was 
understood to be adverse to the whole project, but not 
publicly so. 



THE LEADERS OF OPINION. 187 

A very useful man for Jenner's purpose was Matthew 
Tierney (afterwards Sir Matthew), who was surgeon to a 
Gloucestershire regiment of militia, and was acquainted 
with Jenner at home. " Let Tierney know," Jenner 
wrote to a common friend, "that my new edition 
mentioning his name is published." Tierney was shortly 
after in Edinburgh, and well repaid Jenner for that 
mention of his name. He succeeded in persuading the 
great Dr. Gregory, who had hitherto read nothing on 
the subject,^ to adopt the new practice, almost as a 
personal favour, or at all events on the easiest evidential 
terms. Tierney wrote to Jenner from Edinburgh : " Its 
being received by the professors here will certainly be a 
means of spreading it more rapidly, and I flatter myself 
this is now established." Hardly any assent was more 
important to secure than that of the great medical 
school of Edinburgh. 

In the army cowpoxing had made way under the 
patronage of the Duke of York, who saw Jenner upon 
the subject in London on the ist of March, 1800. The 
Duke of Clarence had given him an interview in 
February. The navy had a very zealous champion of 
Jennerism in the person of Dr. Trotter, the well-known 
author of Medicina Nautica. Trotter had an imaginative 
vein in him, and wrote a five-act tragedy in verse, 
entitled The Noble Foundling ; or, ilie Hermit of the 

' Tierney to Jenner, 21st March, iSoo : " Dr. Gregory, the pro- 
fessor of physic here, knew very little about it, and of course did 
not encourage It. I gave him the sum of my experience, and he 
now seems to entertain more favourable opinions of it. Indeed, he 
did me the unwished-for honour of reading my accounts to his 
class." — Baron, i. 376. 



GENERAL ASSENT IN ENGLAND. 



Tweed. Of the progress of cowpoxing he says : " Like 
the early propagation of Christianity by its Divine 
Leader, it was first preached to the poor. The children 
of poor soldiers and poor fishermen first partook of its 
blessings ; publicans and sinners have since embraced 
it ; and the purity of its doctrine and practice is making 
proselytes to the very Land's End in Cornwall."^ The 
first of a number of medals struck in honour of vac- 
cination was one from the naval medical service, led by 
Trotter, which Jennerhad presented to him in February, 
1 80 1. 

Support of great use as an advertisement, but of no 
intrinsic authority, came from the men of science: 
Wollaston wrote to Jenner, in the year iSoo : "You 
have proved to the satisfaction of every candid person 
that there is a disease of the very mildest kind com- 
municated by inoculation, which perfectly secures the 
constitution from the smallpox." " Blumenbach, the 
celebrated anatomist of Gottingen, wrote to Jenner that 
they had elected him into their Royal Academy of 
Sciences on account of "that immortal work by which 
you have become one of the greatest benefactors to 
mankind," ^ 

Dr. Erasmus Darwin, the famous author of Zoonomia, 
wrote to Jenner on the 24th February, 1802 (a few 
weeks before his death) : " In a little time it may occur 
' that the christening and vaccination of children may 
always be performed on the same day." * Dr. Darwin 
was something of a humorist, and a little tainted wlcli 



k 



' Mid. and Fhys. Jou 
^ In Baron, i. ' 



i. 525 (6th May, iBoo). 
* Ibid., L 541. 



THE PROFESSION TESTIFIES. 1 89 

irreligion ; it is just possible that he was poking fun 
at Jenner. 

On the 19th of July, iSoo, thirty-six of the leading 
physicians and surgeons in London issued an advertise- 
ment in the Morning Herald, in the following terms : 
"Many unfounded reports having been circulated, which 
have a tendency to prejudice the mind of the public 
against the inoculation of the cowpox, we, the under- 
signed physicians and surgeons, think it our duty to 
declare our opinion — that those persons who have had 
the cowpox are perfectly secure from the infection of 
the smallpox. We also declare that the inoculated 
cowpox is a much milder and safer disease than the 
inoculated smallpox." In January, 1801, thirty new 
signatures were obtained in London for this manifesto 
by the indefatigable Ring; and similar declarations were 
made by the chief medical men in York, Leeds, Chester, 
Durham, Ipswich, Oxford, and other important centres. 

Those who thus came forward to lead public opinion 
mostly took their cue from Jenner, who, in his Further 
Observations, published in April, 1799, was bold enough 
to say : — 

"In every instance the patient who has felt its 
influence has completely lost the susceptibility for the 
variolous contagion ; and as these instances are now 
become numerous, I conceive that, joined to the obser- 
vations in the former part of this paper, they sufficiently 
preclude me from the necessity of entering into contro- 
versies with those who have circulated reports adverse 
to my assertions on no other evidence than what has 
been casually collected." The Continuation of Facts and 
\tions, published in December, 1799, spoke of the 



I go 



GENERAL ASSENT IN ENGLAND. 



evidence as then practically complete.' In like manner 
Dr. Huggan, of West Kent, wrote, on 31st December, 
1799 ; " The discussion of the subject will, of course, be 
considered as closed. This is a circumstance truly 
honourable to Dr. Jenner. Exegit monnmeiiiuni aere 
perennius" I 

On the 1st of March, 1800, Dr. Denman re-echoed 
Jenner's own claims as follows: " It appears to me that 
none of the facts or observations mentioned by Dr. 
Jenner have been disproved or refuted, and that no new 
information has been gained on any material point by 
all that has been written on the subject since the publi- 
cation of his first treatise." A pamphlet by Mr. Creaser, 
of Bath, in 1800, speaks of "extensive and impartial 
trials by men of the first talents, independent of concert 
or co-operation. The result is that, although the in- 
oculation of the cowpox is one of the boldest and most 
direct innovations on preceding practice, and as such has 
had to encounter all the impediments which are usually 
opposed to novelty by the operations of scepticism, 
prejudice and interest ; yet its asserted and almost un- 
paralleled advantages have been realized in their highest 
extent by a mass of irresistible evidence. ... It is 
extraordinary how exactly Jenner has been confirmed." 
The confirmation went, indeed, rather too far ; for , 
Creaser himself included in it the horse-grease origin , 
of genuine cowpox, which Jenner was at that very time 



I 



I have the pleasure of seeing that the feeble efforts of a f 
iduals to depreciate the new practice are sinking fast into 
contempt beneath the immense mass of evidence which has risen 
upport of it." (Jenner, l.c.) 



A SPEEDY DECISION. 191 

retiring from. In July, 1800, John Ring, the most 
active of the cowpox propagandists, writes ; " What- 
ever be the origin of vaccine virus, it must give every 
friend to the interests of humanity peculiar pleasure to 
contemplate its end. ... It may now be con- 
sidered as completely established." In September he 
wrote again to say that smallpox inoculation had been 
discontinued since three months at the Inoculation 
Hospital. On the 5 th December, iSoo, Dr. Woodforde, 
of Castle Cary, Somerset, writes that the Jennerian 
practice is now fully established, " every generous mind 
will congratulate himself," 

In June, 1800, the editor of the Medical Journal 
announced that "vaccination is nearly established in 
this island," Simmons, of Manchester, wrote on the 
gth December, 1800: "Perhaps no subject ever met 
with so ample an examination in so short a time, , , , 
If the testimony of medical men in its favour, more 
general than ever was published before on any one 
subject, can be supposed to determine the former [that 
cowpox wards off smallpox], it must be admitted as 
proved beyond all controversy," 

Clement of Shrewsbury, wrote on the i6th June, 1801; 
"I have the pleasure to add that the Jennerian inocu- 
lation is universally adopted by the medical gentlemen 
of this town and neighbourhood." Peck, of Higham 
Ferrers, on 8th June : " It has been left for the present 
period to glory in very important discoveries. Witness 
the indisputable extermination of that dire scourge of 
the nation, the smallpo."c, A Jenner has been ordered 
to arrest its insatiate rage." 

Paterson, of Montrose, on 23rd May, iSoi, confesses 



192 



GENERAL ASSENT IN ENGLAND. 



that he is "lost at once in admiration and gratitudi 
No farther testimony is needed." 

In sending to the Medical Journal a piece of testi- I 
mony from France, James Moore explains, on 5th 
February, 1802, that he does not send it as additional 
proof; for "all opposition to this great discovery seems 
now to be silenced. Like the doctrine of the Circulation J 
of the Blood hy the immortal Harvey, it is already estab- 1 
lished." Huggan, as we have seen, did not wait \ 
long; more than two years before {31st December, 
1799), on the last day of the year in which the practice 
really began to be tried, he wrote that " the discussion 
of the subject will, of course, be considered as closed." ' 

On the I2th September, 1800, Leese, a London prac- 
titioner, writes to the Medical Journal that "the general 
opinion of the most discerning of the profession, as well 
as of the public, now preponderates in favour of the new 
disease." On the 17th September, Huggan again writes 
on alleged failures : " People are weak who believe such 
an occurrence probable, or even possible. Such cases 
may impose upon the credulous, may perplex the minds 
of those who still have their doubts, and may afford a 
malicious and short-lived triumph to the ungenerous 
part of the profession, but can never influence the 
liberal and enlightened." 

It was in vain for such an outsider as " Candidus," in 
the Gentlematis Magazine, to write (nth July, 1799): 
" There is much to be done on this subject, Mr. Urban 
, . . The public mind is by no means satisfied ; and 
indeed it is impossible it should be ; for the story 



APPROVAL liV THE PUBLIC. 193 

hitherto has had more of the appearance of a botth- 
conjurot^s history than of a sober philosophical dis- 
quisition, and could not fail to excite ridicule." 

" Candidus" was a medical man who had retired to 
the country after a busy practice, and was able to apply 
that independent scrutiny which members of his pro- 
fession are then in a far better position to exercise 
than when they are in the whirl of daily business. 

Meanwhile among the public there was the usual 
willingness to accept professional authority. A doctor 
in the Midlands wrote i that the ordinary class of paying 
patients "take the opinion of the practitioners they 
employ, and sometimes commission them to inoculate 
their children 'with either kind of pock.' The upper 
classes judge for themselves, and those among them 
who are philanthropists and converts to the new faith 
inoculate their own children and those of the poor 
together." The nobility and gentry of Gloucestershire 
came forward in 1801, and presented their countryman, 
Edward Jenner, M.D., F.R.S., with a piece of plate. 

On the 17th of March, 1802, Jenner laid before Parlia- 
ment a petition, asking to be rewarded for his discovery. 
The prime minister, Addington, took tlie King's plea- 
sure on it, who strongly recommended it to the con- 
sideration of the House of Commons ; and a Committee 
was appointed to consider it, with Admiral Berkeley, 
one of the members for Gloucestershire, as chairman. 
This was the first opportunity for a public and impartial 
scrutiny of Jenner's claims. 

The Committee was pledged in its very constitution. 



I Stokes, of Chesterfield, in Med. and Phys.Jou 



194 



GENERAL ASSENT IN ENGLAND. 



and made no such scrutiny as a very simple line 
cross-examination would have led to. The Committee 
were hardly qualified to judge on the merits of the patho- 
logical and epidemiological question, and had practically 
no doubt on the empirical evidence of protection. 
They called three adverse witnesses, and gave a further 
show of fairness to their proceedings by hearing a good , 
deal of evidence against the priority of Jenner's claim. ^ 
It was shown that Farmer Jesty had cowpoxed his 
wife and children a good many years before Jenner, 
and there was some evidence that a formal project for 
cowpoxing on a large scale had been communicated, 
shortly after that event, in a letter to Sir George Baker, , 
president of the College of Physicians. So far from . 
damaging Jenner's claim, all the evidence of that sort 
did it good ; it served to show that these ideas had 
been in the air, and that therefore there was some 
general truth in them. It was an obvious conclusion 
for the Committee to come to, that Jenner was entitled 
to the priority inasmuch as he had been the first to 
come before the profession with his Inquiry. The only j 
serious stand was made by Pearson ; and that was, of I 
course, not against the truth and value of cowpoxing, 
but against Jenner's claim to have made it current coin. 
Woodville, whose practical merits were really greater > 
than those of Pearson, gave Jenner the whole credit, and 
did not say a word in support of his London colleague. 
Pearson's attempt to minimize Jenner's merits did not 
make a favourable impression for himself; while it served, 
like the evidence of pre-Jennerian cowpoxing, to rais 
side issue, and to divert any suspicious feeling that the ] 
whole thing was a mistake. 



THE PARLIAMENTARY COMMITTEE. 195 

The Committee, naturally, did not formally overlook 
the great question whether cowpoxing was a preven- 
tive of smallpox. They called evidence as to whether 
cowpoxed persons were incapable of receiving the 
infection of smallpox, whether cowpox inoculation was 
preferable on various grounds to variolous inoculation, 
and whether cowpox could be inoculated without 
injuring the health. The opposition was represented 
by Mr. Birch, Dr. Moseley, and Dr. Rowley, all of them- 
men of good position. They were rather easily disposed 
of by the familiar English device of asking them what 
was their personal experience of the practice in ques- 
tion. They had, of course, to make the damning ad- 
mission that their experience of it, as practised by 
themselves, was nil; so that, on the whole, Birch, 
Moseley, and Rowley were of little account before 
the Committee. They had a fairer field afterwards 
as pamphleteers before the public, who were Just as 
willing to hear the dialectical bearings of the question 
as the House of Commons Committee was unwilling 
to listen to anything but the voice of " experts " and 
authorities. 

The authoritative opinions which the Committee 
heard were monotonous in their approval of the new 
practice. 

Dr. Ash, a leading feilow of the College of Phy- 
sicians, had had three of his own children inoculated 
with it. It is an effectual and permanent security 
against the smallpox, as sufficiently proved by the 
immense body of experiments (which the doctor could 
hardly have read with care, or he would not have spoken 
so). 



igS 



GENERAL ASSENT IN ENGLAND. 



Sir Everaud Home, F.R.S. (who had advised the 1 
Royal Society to reject Jenner's Inquiry), said that his 
own opinion was best stated by his having had one of ] 
his own children inoculated with vaccine matter, and he f 
is perfectly satisfied with its security. 

Dr. Woodville gives the preference to the vaccine ( 
over the smallpox inoculation because he finds 
equally certain in securing the patient from the smali- 
■ pox, and because it is without danger or risk of life, and 
not, like the smallpox, contagious. 

Sir Gilbert Blank was at first prejudiced against I 
cowpoxing, owing to the numerous cases of smallpox 
eruption conjoined with it at Woodville's hospital. 
Afterwards he vaccinated one of his children, who went 
through it perfectly well and has since resisted the 
variolous infection, which was performed seventeen 
months after the other. If the vaccine was universally 
substituted, he thinks the smallpox must in a short , 
time be extinct. The objections to it were grounded on | 
fallacy or misrepresentation. 

Mr. Francis Knight, Inspector-General of Army 1 
Hospitals, had seen some cases of the spurious kind. 

Mr. John Griffiths, surgeon to the Queer 
Household and to St. George's Hospital, had inoculated 
upwards of fifteen hundred persons with cowpox, not I 
one of whom had any untoward symptoms. He does not 
speak of the variolous test. 

Dr. Denman believed vaccine to be a perfect pre- 
ventive of smallpox, if properly conducted. 

Dr. Croft had his own children vaccinated, and had ■ 
uniformly recommended the new protective to his , 
patients. A greater blessing to mankind than any i 



EVIDENCE OF THE MEDICAL LEADERS. 197 

other discovery ever made in medicine. Would cause 
the snnallpox to be remembered only by name. 

Dr. NEL.SO.N, of the Vaccine Pock Institution, be- 
lieved that about 700 persons had been inoculated at 
that Institution, who had all done well, and none had 
since then taken smallpox either from inoculation or 
otherwise. The health of sickly children in general much 
mended by vaccine. 

Sir George Baker, F.R.S., physician to their 
Majesties, knew of no instance of cowpox inoculation 
creating or e.-cciting any constitutional disorder, or of 
its being fatal. 

Dr, Thornton, of the Marylebone Dispensary(author 
of Vindici<2 Vaccind), had inoculated with cowpox two 
children of Lord Somerville's coachman ; heard after- 
wards that they had both taken the smallpox ; their 
cowpox must have been spurious. Dr. Jenncr had 
elucidated the very obscure subject of spurious cowpox. 

Mr, Keate, Surgeon-General to the Army, surgeon 
to the Queen and to the Prince of Wales, gave the new 
practice his general approval. 

Dr. Lister, physician to St. Thomas's Hospital 
(who had assured Cline as early as July, 1798, that he 
was sure cowpox was a protective), was now called tc 
explain away a case of failure to protect, which he did 
very fluently. 

Mr. Cline had been convinced from the first, and 
had recommended cowpox strongly to all his friends, 
including Sir Walter Farquhar. Cases of failure must 
have been done with spurious matter. 

Dr. Bradlev, physician to the Westminster Hos- 
pital (and editor of the Medical and Physical Journal, 



T98 



GENERAL ASSENT IN ENGLAND. 



i 



in which he had pledged himself to the utmost to back I 
up Jenner), believed that cowpox will prevent smallpox j 
to the extent of human life. Thinks that if Dr. Jer 
had settled in London and kept cowpox a secret, he | 
might have made ten thousand a year for the first five I 
years, and double that sum afterwards. 

Sir WALTtK FakqUHAR, M.D., had seen cowpox 
in one of his grandchildren, who had it very mildly and 
was protected by it. Thinks it a permanent security. 
Believes that an income of ten thousand a year was lost 
to Dr. Jenner by making the secret public. 

Dr. James Sims, president of the Medical Society, 
thinks Dr. Jenner might have become the richest man in 
these kingdoms by trading on his cowpox secret. The 
Medical Society of London sent through him a unani- 
mous testimony in favour of cowpoxing. 

Dr. Saundiirs, physician to Guy's Hospital, thinks . I 
cowpox bids fair to extirpate the poison of smallpox. I 
If Dr. Jenner " had rendered the subject more studiously J 
mysterious, and by that means secured to himself i 
some degree a monopoly of the practice, instead of J 
acting in the libera! and candid manner he had done, it I 
would have been a source of much greater emolument 1 
to him." 

Dr. Lettsom, F.R.S,, believed that cowpox secured I 
the person from smallpox as much as the inoculation of I 
smallpox does. Two relations of his, variolated in the f 
Suttonian way, had afterwards taken smallpox, and one I 
of them had died. Had attended two other patients in 

smallpox, boUi of whom had been inoculated i 
with smallpox a year or two before. 

Dr. Frampton, physician to the London Hcspital, ( 



JENNER BEFORE THE COMMITTEE. 199 

had never found cowpox fail in preventing the attack of 
smallpox ; had tried it on three of his own children, who 
had stood the variolous test three several times. 

Dr. MatTHKW BaiLLII;. late physician to St. George's 
Hospital, had gone to see a feiv cases of inoculated cow- 
pox, in order to become thoroughly acquainted with the 
appearance and progress of the cowpox pustule, A 
patient who has properly undergone the cowpox is per- 
fectly secure from the smallpox. Spurious cowpox was 
so difficult a question, that Dr. Jenner's iinowledge of the 
genuine sort would have enabled him to make a con- 
siderable fortune if he had traded on it. The most 
important discovery ever made in medicine; would ulti- 
mately banish the smallpox from the class of diseases. 

The Committee tooktheir pathology almost exclusively 
from the Rev. G. C. Jenner, the curate who had tried until 
fifty times to vaccinate himself, and had produced spurious 
cowpox only then. They took the iiistory of the rise and 
progress of the cowpoxing idea from the lips of the great 
discoverer himself, who omitted the horse-grease part of 
the comedy. The Committee heard no reference to horse- 
grease from first to last, nor do they seem to have had the 
smallest curiosity to know what sort of pox the cowpox 
really was. They were re-assured over and over again that 
it was not catching, like smallpox, that it was mild when 
inoculated on the arm, that no one ever died of it, and 
that, if it were not spurious, it was a certain preventive of 
smallpox. If they had read the cases published even 
by the friends of the practice, such as Ward's cases at 
Manchester, they would have found that the variolous 
test had failed in the most obvious way in a good many ; 
and if they had inquired into the larger number of cases 



GENERAL ASSENT IN ENGLAND, 



k 



where the variolous test had apparently proved the 
prophylactic virtues of cowpox, they would have found 
that the patients had usually developed about as much 
of smallpox as the inoculative methods of the time were 
calculated to produce. i 

It was unfortunate that the only persons who had a 
motive for scrutinizing the Jennerian evidence, namely ' 
the friends of the old variolous inoculation, had also a 
motive for not inquiring too closely into the shadowy 
or formal type of the variolous test. They would j 
probably not have been listened to ; but, as it was, the 
opportunity was missed of showing how the profession I 
had been deceived, or had deceived themselves, on the 
grand question of the antagonist character of cowpox. If 
the variolous test had been shown at that date to be the 
meaningless thing that it was afterwards admitted to be, 
even Admiral Berkeley and his fellow committee-men 
could hardly have reported as they did. It was part of 
the peculiar irony of the situation that the only oppo- i 
nents of the Jennerian doctrines were precluded, by their 
own interest in variolation, from attacking these doc- 
trines on the ground of the variolous test. The apparent 
success of that test was what chiefly gained assent ; it was 
really the most vulnerable point in the Jennerian theory 
as stated for public apprehension ; but, to have shown 
that the trifling effects usually produced by variolation in 
a cowpoxed subject were neither more nor less than the 
usual results of Suttonian variolation when there xvas no 
question of cowpox at all, would not have served the 
purpose of the Suttonians, for it would have placed the 
formal and illusory character of their own prophylaxis 
in too glaring a light. Moseley himself was impressed 



DECISION' OF PARLIAMENT. 201 

by the evidence of the variolous test ; he admitted that 
cowpox might hinder the development of variola for a 
time, perhaps for two or three years. Birch and Rowley, 
in their evidence, did not adduce any of the numerous 
cases where experimental variolation following cowpox 
had produced an average degree of smallpox, but only 
a few cases where the cowpoxed had taken the small- 
pox in the natural way by contagion. Thus the body of 
experimental evidence was allowed for the time to pass 
unchallenged ; and there can be no question that it was 
upon the experimental evidence that the verdict really 
turned. 

The Committee reported to the House that the claim 
of Dr. Jenner's petition had been established : " As soon 
as the New Inoculation becomes universal, it must abso- 
lutely extinguish one of the most destructive disorders 
by which the human race has been visited." On the 
2nd of June, 1802, Admiral Berkeley proposed in the 
House a grant to Jenncr of ^10,000, to which Sir Henry 
Mildmay moved an amendment {lost by 56 to 59) to 
make the sum £10,000. The prime minister, Addington, 
a notorious worshipper of authority, and more ignorant, 
naturally, of pathology and epidemiology than of most 
things, gave it as his opinion that cowpoxing was among 
the greatest, if not the very greatest of discoveries since 
the creation of man, Mr. Windham, Mr. Wilberforce, 
and Mr. Grey were all convinced, and spoke handsomely 
of Jenner. The substantive motion was put to the vote 
and carried unanimously : " That it is the opinion of the 
Committee that a sum not exceeding £10,000 be granted 
to his Majesty to be paid as a remuneration to Dr. 
Edward Jenner for promulgating the discovery of the 



GENEKAL ASSENT IN ENGLAND. 



^ 



Vaccine Inoculation, by which mode that dreadful 
malady the small pox was prevented." ^ 

The Annual Register'^ remarks that the public were 
highly gratified by this munificence. Admiral Berkeley's 
Committee, it seems, had left no means untried to pro- 
cure cases hostile to the efficacy of this noble invention, 
but in every instance the result was highly satisfactory. 
At the same time the gallant Admiral is commended 
as having been from the first "the friend and patron of 
Dr, Jenner," and as having " brought his discovery for- 
ward to notice through the medium of his high rank 
and great connections, and pressed it upon the attention 
of the nation by procuring the unanimous approbation 
of parliament to the discoverer." Just so ; it is a useful 
thing to have an aristocratic friend who is strong enough 
to procure the unanimous approbation of parliament. 
Only, a less naive chronicler would not have put the 
matter quite so plainly. Mr. Bankes, member for Corfe 
Castle, who had sat on the Committee, said in the debate 
that, although he considered the discovery a useful one, 
yet he looked upon the report of the Committee with 
some degree of jealousy. The members of it appeared 
to him " in the light of nominees on a committee to try 
the merits of a contested election, as being the friends 
of the petitioner,"^ Bankes, having been a member of 
it himself, was in a good position for forming an opinion. 
It is on record that Jenner fell into so despondent a 
mood while the evidence was being taken that he 



h. 



' Enrfipean Mag., xlii. 137. 

» For 1802, p. 183. 

■ Morning Herald, 3rd June, 1S02. 



THE BERKELEY INTEREST. 203 

actually talked of abandoning his claim, and was pre- 
vented from doing so by the assurance of Admiral 
Berkeley that it would all come right. 

This judgment of the House of Commons, based upon 
that of the medical leaders, gave a great support to the 
doctrine and practice of cowpoxing both at home and 
abroad, a support which proved invaluable when the 
epidemic of smallpox returned in 1804--5, ^^^ exhibited 
the protective in its true light to the eyes of those who 
were most immediately concerned with the practical 
results. Meanwhile we have to see how the Jennerian 
novelty was received abroad. Foreign opinion was 
bound to react upon opinion at home and was after- 
wards publicly appealed to, Wilberforce in particular 
being impressed by the consensus of all Europe. Ger- 
many, Austria, France, and Italy had famous medical 
schools, as well as academical societies of great authority 
and renown. The reception which foreign countries 
gave to the English project for exterminating smallpox 
deserves as careful an examination as the reception 
which it met with in the country of its birth. 



CHAPTER IX. 

THE GERMAN ENDORSEMENT. 

THE adoption of cowpoxing by foreign countries 
has always been considered one of the best 
arguments for the truth of the doctrine and the value 
of the practice. To this medical innovation the famous 
aphorism of St. Augustine has been confidently applied : 
Seciirus judicat orbis terrarum. The defender of vacci- 
nation in the blue-book of 1857 waxes eloquent over 
**the common convictions of mankind."^ An English 
statesman and critical historian, who had a trained eye 
for fallacies and illusions, Sir George Cornewall Lewis, 
has adduced vaccination as a striking instance of the 
beneficent influence of scientific authority upon popular 
opinion. After a few years, he said, the Jennerian 
teaching " had been brought to a certain test, and had 
made its way in all countries." 2 That it made its 
way in all countries, and very quickly too, is un- 
questioned. The point of Sir George Lewis's argument 
is, that vaccination was brought to a certain test, that it 
rested on scientific evidence, that it was promulgated by 

^ Papers on the History and Practice of Vaccination, Presented 
to both Houses of Parliament, 1857. 

2 Influence of Authority in Matters of Opinion^ 2nd ed., p. 36. 

204 



SCIENTIFIC AUTHORITY. 205 

the respectable authority of the medical leaders after 
they had duly satisfied themselves, and that it was 
rightly accepted by the people as having been found to 
be all that it claimed to be. The same philosophical 
historian, who finds in the early Roman history an un- 
limited field for scepticism, and an occasion for insisting 
on a standard of evidence which most persons will think 
impracticable, finds in the latter-day cowpox legend a 
happy illustration of the trustworthiness of scientific or 
medical authority. The argument from common con- 
sent has seldom been used with greater effect than in 
the case of the Jennerian mystification ; the sceptical in 
everything else are not sceptical here, because vaccina- 
tion has been established in the very age of science, 
under the cognisance and approval of the scientific 
body, and by the almost unanimous voice of the medical 
profession in all countries. Writers of the Cornewall 
Lewis school show a confidence in scientific and medical 
authority which no one can share who has made it his 
business to study the history of scientific and medical 
developments. Scientific or medical authority arises 
under the same mundane influences as all otlier authority. 
This is not the place to set forth the full psychological 
grounds for rating scientific authority in doctrinal matters 
at no higher value than any other kind of authority. 
We are here concerned with the scrutiny of a small 
fragment of established medical doctrine. When the 
result has been made clear, those who will may point the 
moral for themselves. 

Jenner's first formal scientific recognition abroad was 
his election, in the autumn of 1801, into the Royal 
Academy of Sciences of Gottingen. Blumenbach, the 



2o6 



THE GRRMAN ENDORSEMENT. 



illustrious anatomist, announced the fact to Jenner 
the 1 3th September, and took occasion on his own part 
to compliment him on "that immortal work by which 
you have become one of the greatest benefactors of 
mankind." Merely on the face of it this recognition 
was of great value. Gottingen had maintained a high 
standard for science and scholarship ever since the 
Georgia Augusta University had been called into ex- 
istence in that third-rate country town, in 1734, by the 
magic wand of George II. The greatest care had been 
taken of its academical repute ; the choice of professors 
continued for many years to be a matter of the most 
anxious thought to the Elector's ministers. The conse- 1 
quence was that an immense concourse of students of 
all the faculties flocked to the homely little place. The 
professors were alive to every movement in the learned 
and scientific world ; the academical voice of Gottingen 
was authoritative in no ordinary degree. 

There were also special reasons why the deliverance of 
the Academy of Sciences upon the new Jennerian project 
should carry great weight. Hanover had taken the lead 
in Germany in trying the new method of inoculation, 1 
just as it had been the centre from which the original 
smallpox inoculation had spread over Germany a gener- 
ation or two before. Ballhorn, a rising young physician 
of the capital, translated the Inquiry into German in 
1799, and the Ftirtlier Observations, along with Wood- 
viile's Reports, the year after. In February, iSor, he 
published a treatise in French, in conjunction with 
Stromeyer, a court sui^eon, on the results of their own 
experience of cowpoxing up to that date.i In Gottingen 



THE g5ttingen academy. 207 

itself the practice had been tried in 1800 by Osiander, 
professor of midwifery, and by Arnemann and Warden- 
burg, the directors of the surgical clinics. In the summer 
of 1801, Osiander published a disquisition on Cowpox,^ 
including an account of the Gottingen practice and a 
minute record of his own cases. "Perhaps never before," 
he says, with reference to that locality, " has a method 
of the kind been so widely diffused in so astonishingly 
short a time, or adopted with so great zeal and un- 
selfishness by medical practitioners, who saw before them 
a certain prospect of diminished incomes in taking these 
measures to ward off the smallpox." 

Here, then, was the experience at their own door for 
enabling the Gottingen Academy of Sciences to form 
a correct judgment upon the doctrines and pretensions 
of Jenner. We shall see how Jenner gained their suff- 
rages. He had sent to Blumenbach, professor of 
Anatomy, and the greatest personage in the medical 
faculty, a copy of his collected cowpox essays by the 
hands of an English student, accompanied, it would 
seem, by a copy of or a reference to his Cuckoo paper 
in the Philosophical Transactions, and a reference to 
another paper which he had on hand for the Royal 
Society on the Migration of Birds. These credentials, 
together with common report, appear to have satisfied 
Blumenbach, who proposed him for election at a meeting 
of the Academy. Osiander, Arnemann, and Warden- 
burg were the members to whom their colleagues would 
look more especially for guidance in a matter which 



208 



THE GERMAN ENDORSEMENT, 



most of them knew nothing of, and their testimony mayTl 
be judged of by the fact that Jenner was elected by ' 
acclamation. Let us now see what native experience 
this authoritative endorsement had behind it. The re- 
velations here are more curious than anything that we 
have seen concerning the reception of Jennerism in the 
country of its birth. 

The most obvious thing in Osiander's book is his 
child-like readiness to accept every statement, conclusion, 
and promise of Jenner without scrutiny. He believes 
In the immunity of the cowpoxed from smallpox as 
absolutely as if vaccination had been practised for a cen- 
tury and had proved an unqualified success. He adopts 
the apologetic argument about " spurious cowpox" with- 
out the smallest hesitation, reproducing the horse-grease 
doctrine in a mechanical way, as if he hardly saw its 
bearing. He has no suspicion of the unwarranted 
liberty that Jenner had furtively taken in his title VarioltB 
Vaccince ; for he gives Kuhblattern and Blattern der 
Kiihe {smallpox of the cow) among the synonyms of 
Kuhpocken. He is especially indignant with Dr. Johann 
Valentin Miiller, of Frankfurt-on-Main, who had issued 
a pamphlet to the laity, calling upon them to reject 
cowpoxing as an untrustworthy protective, inasmuch as 
cowpox had no connexion whatsoever with smallpox. 
It would never do, says Osiander, to reason in that 
theoretical way, and to reject the plain teaching of facts 
and experiments. Had it not been shown by hundreds 
of experiments, both in England and elsewhere, that 
the cowpoxed could not take smallpox? After this 
bold appeal to experiment, we turn, naturally, with some 
interest to the minute account of nine cases of his own, 



VARIOLOUS TEST AT HANOVER. 209 

in September and October, 1800, and in February, 1801 ; 
but in not one of these do we read of the variolous test 
having been applied. Perhaps he trusted to Ballhorn 
and Stromeyer to have applied it. Let us see, then, 
how much scrutiny these medical men applied to this 
new kind of protective pox which had come to them 
from over the sea. 

In April, 1800, Stromeyer wrote to a London cor- 
respondent ' tiiat Ballhorn and himself had applied the 
variolous test in only one of their vaccinated patients 
that year, and that the variolation in that case had pro- 
duced the local pustule. One naturally supposes that 
they had fully satisfied themselves in their practice of 
the year before, and that they saw no use in trying the 
variolous test any longer. As a matter of fact, Ballhorn 
and Stromeyer, the pioneers of cowpoxing in Germany, 
tried the variolous test just five times; thrice in 1799, 
and twice in 1800, "We repeat here," they say in the 
French treatise of 1801, "our most solemn assurance 
that none of these variolous inoculations had the 
smallest effect." But let us loolc at the facts with our 
own eyes. 

Of the tliree earlier cases we have only scanty particulars : ' one 
was vaccinated on 17th June, 1799, and tested with smallpox on 
t4th August ; another was also vaccinated in June, and tested on 
the 22nd of September ; the third was vaccinated on the 28tli of 
May, 1799, and tested in January, 1800. The smallpox in all three 
was "ganzlich unwirksam " (quite without effect). But, of the 
preceding vaccinations of these same children, we also read that 
"there were almost always obdurate and callous ulcers left behind 
on the arms" ; so that in at least the two cases tested within a few 

' Med. nnd Phys. Jourti., iii. 

* Hu/elaiuCs Journal, x. pc, 3, p, 106. 



210 THE GERMAN ENDORSEMENT. 

weeks of being cowpoxcd, there was a simple explanalion of tlH 
smallpox aborting. 

Of the two cases tested among the vaccinations of I 
cowpoxed on the 3rd of February, suffered in due course from a 
general vaccinal eruption, was tested by the inoculation of small- 
pox on the 19th of March, and developed a correa variolous 
pustule, which went through the full stages, and was still covered 
by a CMist on the twelfth day; its vaccinal eruption would itself I 
have sufficed to check whatever general eruption the mode of in 
oculalion of smallpox matter (by lancet-puncture) was likely t 
have produced on a fair field The other child, tested in iSoo, had.4 
been vaccinated the year before (30th June, 1799) ; a sister, whose I 
vaccination in June, 1799, had failed, while her brolber'a had suc- 
ceeded, was also tested with smallpox as a controlling experiment. 
The two children had Che smallpox matter inserted on the 24tli 
April, at an incision on the right arm of each, and again on the 
Z5th by means of threads soaked in the matter and introduced 
into a small blister which had been raised on the left arm of eocH 
for the purpose. In neither child did the incision-spot produc 
pustule ; in both the blister- inoculation ran almost the same active J 
course, and had become a crust on the ninth day. The chief ■ 1 
difference was that the sister, whose vaccination had failed, de- 1 
veloped close to the blister a single smallpox pimple or pustule on 
the tenth day, which died away in less than forty-eight hours. 1' 

There tJoes not seem to be much to choose between 
the result of the test in the vaccinated brother and the , 
unvaccinated sister ; but the authors solemnly concluded 
that the variolous test came to nothing in the brother, 
thanks to his cowpox, whereas the sister's inoculation 
had really given her the smallpox, although "extr^me- 
ment b^nigne et l^gere." Down to the end of the year 
1800, Drs. Ballhorn and Stromeycr had vaccinated five 
hundred children with their own hands, and in j'ust 
five of these had they experimentally asked the great 
question by means of the variolous test — with what ' 
result or under what circumstances we have now seen. 



THE REAL TEST. 



211 



However, the great question was getting itself asked 
in those months without any experiment, and was get- 
ting itself answered without any ambiguity. Smallpox 
was prevalent with varying intensity among the children 
in various towns and villages of Hanover and Bruns- 
wick, and in Bremen, Hamburg, and other parts of 
North Germany. The disease rose to epidemic inten- 
sity at one place after another, and the alarm that it 
caused made tlie people more inclined to submit their 
children to the new inoculation. Ballhorn^ assures us 
that many allowed it to be tried at first merely as a 
harmless thing (which, however, it was not, as his own 
experience of slow ulcers showed), and with no great 
belief in it; but that the subsequent outbreak of epi- 
demic smallpox made them take to it more seriously. 
Lentin, another Hanover physician, wrote to Hufeland^ 
on the 27th July, 1800, that they were awaiting the rise 
of smallpox to the height of an epidemic, so that the 
efficacy of cowpox inoculation might be tested. At that 
date, he says, they knew of no authentic case where a 
vaccinated child had caught smallpox, no matter how 
much it had been " exposed " ; but he gives immediately 
after a case in Hanover, vouched for by Drs. Miihry and 
Lodemann, in which a child had been vaccinated to 
protect it from the smallpox then in the house, and had 
taken the latter disease a fortnight after its vaccination. 

Ballhorn adduces the following as examples of cow- 
poxed children successfully tested by exposing them 
to smallpox: In the winter of 1799-1800 there was 



' HufelantCs Journal, y. 
* Ibid., X. pt. a, p. 185. 



pt. 3, p. 106. 



THE GERMAN ENDORSEMENT. 



a great mortality from smallpox among infants . 
children at Langenhagen ; he proceeded thither and i 
vaccinated three children, none of whom caught the-] 
epidemic disease, although they were in the midst of it,] 
Now, who were these children? One was the child of I 
Herr von Stapper, another of Pastor Holickcr, the third | 
of Lieutenant Dreschler — ^just the class of persons 
might be expected to have good houses and to keep ' 
their children out of harm's way. By the month of 1 
February, iSol, when Ballhorn published his book on , 
cowpox, he had to admit a certain number of cases In | 
Hanover, in which the epidemic contagion had taken ' 
hold in spite of their recent cowpoxing ; but these cases, I 
he says, had been vaccinated either imperfectly or with \ 
"spurious" matter. No details being given, it is im- 
possible to follow him here. 

Let us take, rather, a remarkable series of events at 1 
the small Brunswick town of Oebisfelde in the summer j 
and autumn of 1801, or at the very time when the ] 
Gottingen Academy of Sciences was honouring Jenner 1 
for his immortal discovery. Professor Wardenburg, of I 
Gottingen, was one of those who reported the oc» 
currences;^ Professor Lichtenstein,^ of Helmstadt, was I 
another; and Dr. Muhleiiheim^ was a third, TheyallJ 
agree about the facts, and no one else ever questional^ 
them. In June, 1801, matter was taken from a child'Ss 
vaccine vesicle and inoculated on several more, and so-l 
on through four successive generations, until forty-ninel 
children had been successfully vaccinated. From the] 



' Hufelaiid's Journal, y. 
' Ibid., p. 117. 



■. pt. I {1802), p. 87. 



' IbU., p, 107. J 



THE OEBISFELDE DISASTER. 213 

description given, the vesicles must have been large 
and tumid, the areola of full extent, and the constitu- 
tional disturbance considerable; the crusts fell off usually 
about the end of the third week ; the lymph was of the 
"clearest and freshest" kind, and was taken from arm to 
arm. Of these forty-nine vaccinated infants, no fewer 
than forty-five took smallpox in the ordinary way during 
the months of August, September, and October, five of 
them having taken it while the cowpox was on them 
and the other forty at a longer interval. 

Whoever is curious to see how far a German medical 
professor could go in the way of sophistical excuses when 
he once began, should read the paper by Wardenburg 
in Hufeland's Journal. It appears that the first child 
in the series, who furnished the vaccine for the other 
forty-eight, had no Blattertianlage, or disposition for 
smallpox ; he had been inoculated with variolous matter 
before, and had not taken ; he had been exposed to 
contagion, and had not taken ; he was, in short, an in- 
corrigible child so far as smallpox was concerned. Was 
it surprising that cowpox matter from such a child's 
vesicle (however correct the vesicle might look) should 
fail in antagonizing smallpox ? The matter wasfaise in 
its source, and, for all its fine appearance, it was false 
in its transmissions through each of the four sets of 
children. " From such a source matter would have been 
falsified even if it had involved a million infants," and 
not these unfortunate forty-five only. This was the 
Gottingen development of the great doctrine of Spurious 
Lymph. Wardenburg thus solemnly adjures a colleague, 
supposed to be confronted with a case of smallpox after 
cowpox: "Hast du nicht in diesem Falle vielleicht 



314 



THE GERMAN ENDORSEMENT. 



falsche Schutzblattern erzeugt?" (Hast thou nol 
haps raised spurious protective pox in this case ?] 
Because, if he had, it was no wonder the protection li 
failed. A singular anticipation of Wardenburg's i 
velopment of the plea of spuriousness, out of the rather ] 
unpromising fact that the vaccine lymph had come 
through a child who could not be made to take small- 
pox, is furnished by De Carro,' the pioneer of cowr- J 
poxing in Vienna. He vaccinated a count who had 
long ago gone through the smallpox ; a good cowpox 
vesicle arose, from which source twenty-one others w 
successfully vaccinated, at Geneva, by Dr. Pelchier, who 
had been in Vienna and had admired the perfect vesicles 
of De Carro's case. But, under tliese peculiar circum- 
stances, the cowpo.'^ failed to protect them from the 
inoculated smallpox some months after ; tliey all took i 
smallpox, though mildly ; and then it was remembered ' 
that their common vaccinifer, then aged forty, had 
suffered from smallpox when he was a child of five. 
His Blatlernanlage had, in fact, been exhausted; whereas, j 
in Wardenburg's case at Oebisfelde, the BlaUernanlagt\ 
had been wanting from the first. 

Returning to the practical lessons of the Oebisfelde coU 1 
lapse, Wardenburg asks, Shall we, therefore, now abandon ', 
cowpox inoculation ? and answers with emphasis, Cer' 
tai/ily not .' By the time he wrote of these events, but , 
not before the catastrophe itself, he and his Gottingen | 
colleagues had pledged their academical credit to Jcnner. , 
They had gone rather too far to turn back, but they j 
could at least put on the whole armour of apologetics. 



' Hu/eianiri Journal, x. pt. 4 (iSoo), p. 129. 



EXPERIENCES AT BREMEN. 215 

I shall give one other North German instance of ihe 
gross and palpable failure of cowpoxing in the very first 
year or years of its trial. In 1801-2 the epidemic 
smallpox was in Bremen, where Dr. G. H. Jawandt 
vaccinated sixty-two children.' He was forced to con- 
clude that cowpox did not ward off the contagion of 
smallpox, unless there had been sufficient erysipelatous 
redness and induration round the vesicle, unless the 
whole system had been aifected, and unless the fever 
had been present of a remittent type. These, of course, 
are rather hard conditions, not often satisfied. He 
gives cases of his own, where smallpox had followed 
what we should esteem a good, fair, average vaccination. 
In one of these, a child aged five, the vesicle ran the 
regular course, there was fever on the ninth day, and 
areolar redness on the ninth and tenth ; three weeks 
after, on visiting the tenement to vaccinate others, he 
found this little girl running about with a full crop of 
smallpox pustules on her. This "deceptive case," he 
says, is accounted for by the fact that the erysipelatous 
areola was not of the right sort; there was not enough 
induration of the tissues beneath. Unless we attend to 
these little things, a good cause will be injured. The 
paper has a postscript to say that, since writing the 
above, several children have caught smallpox who are 
said to have had complete (?) cowpox ; but all these 
children had been vaccinated by surgeons. This should 
be a lesson to us not to allow vaccination to be practised 
as a mere handicraft. Dr. Jawandt himself belonged to 
a higher grade of the profession, and was jealous for the 



I 



2l6 



THE GERMAN ENDORSEMENT, 



honour of his caste ; but, unhappily, the smallpox had I 
paid no more respect to vaccination when it was im- 
parted by his own skilful hand than when it was done 
by a common Chirurgus.' 

The experimental variolous test at Bremen was no 
more satisfactory than the epidemic test. The chief 
vaccinator there. Dr. Albers, had cowpoxed four hundred 
children, and tested "several" of them, five or six 
months after, with smallpox : " The only effect was a 
rather severe inflammation of the inoculated spot, which, 
however, gradually began to decline on the days when 
the eruption should have appeared " - — a rather general 
statement, but one that might easily cover an average 
amount of variolation as induced by the mild methods 
then in vogue {see chapter vi.). 

Before leaving this part of Germany, we may glance 
at the reception of cowpox in Denmark. The Commis- 
sion (Winslow, Callisen, and others) made no variolous 
tests ; but they issued a very strong report, in which we 
read : " From the experiments of other nations, particu- 
larly the English, there are reasons to hope that the con- 
tagion of the natural smallpox throughout futurity can 
be entirely annihilated by the vaccine."' 



' An English lady, Mis 

alt these learned Germans 

with her own hand, up t 

each to as many of them 

taken smallpox. Only on 

but opposite to his name : 

indicating, she afterwards thought, 

something wrong. 
' Medicinisch-Ckiritrgiscke Zeitung (Salzburg), 
' Report of 19th December, 1801, In Baron, i. 4 



Bayley, of Hope, near Manchester, put 
the blush. She h.id vaccinated 2,600 
November, 1805, and offered a crown 
i could afterwards show that they had 
little boy came to claim the premium ; 
her books Miss Bayley found a remark 
licion that there was 



I Sot, i 



. p. 448. 



FIRST TRIAL AT BERLIN. 



217 



While these experiences were being gained in Han- 
l tJver, the new practice was being tried in Prussia. At 
I Berlin the Jennerian project had from the first the 
f-advantage, or disadvantage, of a certain amount of 
I- Court patronage. In December, 1799. Jenner had been 
requested to send matter for the vaccination of the 
Princess Louisa,' and through that Court channel Privy 
Councillor Dr. Heim had come to know Jenner's writ- 
ings and to make trial of cowpox.' He vaccinated 
several children, and found the course of the disease to 
be very much as jenner had described and figured it. 
He tested one of his cases, a girl of eight, with inocu- 
lated smallpox four weeks after vaccination, and found 
her protected ; he tested also an unvaccinated brother 
of the former, and found him not protected ; the sister 
slept in the same bed with the child suffering from 
inoculated .smallpox, but did not catch the complaint : 
"so that I must conclude that having had the cowpox 
is a protection against the infection of smallpox." He 
had heard when a boy from his father, who kept 
some cows, that the milkmaids were subject to a pox 
from milking, but he had been told " nichts weiteres," 
i.e. there was no tale about their protection from small- 
pox. 

Hufeland, professor of medicine at Berlin (having 
been called from Jena in 1799), was really enthusiastic 
for Jennerism,^ although he made believe to hesitate a 



I 



' flu/eland's /ounial, x. pt. 2, p. 187. 
ce of it (/.^.x. pt. z, p. 189) he argues that, if vac 
ersally enforced all over the world for a sing-It 
St of necessity become extinct. It was a matlie- 



3 THE GERMAN ENDORSEMENT. 

litte at first. As an editor, he was so far open on the 
question that he admitted into his Journal a hostile 
paper of log pages by Professor Marcus Herz, " one of 
the foremost of our philosophical physicians," as he 
said in an editorial note to the paper. One of Herz's 
more practical points was that very few cases had been 
subjected to the variolous test, and that of these few 
some had yielded an equivocal answer; ^ to which Dr. 
Michaelis, garrison surgeon at Harburg, replied in a 
paper of 74 pages that Herz ought to read the report of 
the Vaccine Pock Institution of London, showing that 
2,110 variolous tests had been applied in 4,000 vaccina- 
tions, and that not one had failed. And besides, he 
asks, have there not been many cases tested in Ger- 
many? Herz ought therefore to withdraw his words 
about very few having been subjected to the test.^ 

In 1801 Hufeland issued, in \\\& Journal, an Appeal to 
the Medical Profession throughout Germany to send in 
their experiences of cowpoxing. The great experi- 
ment, he wrote, is gradually approaching a conclusion 
very favourable to the business and to the wellbeing of 
mankind. Thousands of instances proclaim aloud the 
usefulness of the discovery. But let us have the truth ; 
failures are as important to know as successes. Indeed, 
we have sufficient of successes already. To investigate 
the circumstances in which cowpox has failed to protect 
will be the best means, in fact the only means, to silence 



matica! demonstration ; there would ben 
the earth, and it would not arise de novo. 
' Huj'eUind's Journal, xii, pt. 1, p. i. 
Ibid., xii. pt 4, p. I. 



INQUIRY BY PRUSSIAN OFFICIALS. 



i floating about of the failures and injurious 
■ effects of vaccine at one place or another. To this 
■appeal, he says, in a later number, he had received a 
good many replies, of which he did not publish any 
considerable number. The most important are those 
relating to the failures at Oebisfelde and Bremen 
already noticed. The balance of evidence, he says, is 
very much in favour of Jenner's claims — as if such a 
question could be settled by setting off so many failures 
against so many apparent successes. 

An official circular, drawn up by the Ober-Collegium 
for Medical Affairs and signed by the minister Graf von 
der Schulenburg, was issued on nth July, iSoi. It is 
addressed to the medical profession in Prussia, and 
calls for an impartial scrutiny of the evidence relating to 
cowpox. It suggests that the new practice should not 
be hastily condemned : good things like antimony, 
Jesuit's bark, and variolous inoculation {which is now 
rewarded with State premiums) had been mistakenly 
opposed at first. But the experience of several years 
would be needed ; enthusiasm for the practice should 
be kept within bounds. Only the qualified profession 
should make the trial, and send their results to the 
sanitary boards of their respective provinces, according 
to a blank form subjoined. The differences between 
genuine and spurious cowpo.-i are then briefly set forth 
for the guidance of those about to make this national 
trial. 

The king, Frederick William III., was at this time 
interested in the question, but by no means persuaded. 
Hofrath Dr. Schul?,, body physician to Prince Ferdinand, 
having written for leave to vaccinate the children in the 



220 THE GERMAN ENDORSEMENT. 

garrison at Potsdam, the king replied, from Charlotten- 
burg, 27th June, 1801, that he considered the evidence 
hitherto to be ambiguous, and that it would require 
several years' experience (the same phrase that was after- ' 
wards used in the official circular of nth July) in order 
to form a safe judgment. So long as there was uncer- 
tainty, he could show no public favour to the Jennerian 
method. No leave was needed for the children at 
Potsdam ; it was the personal privilege of any one to get 
vaccinated if he pleased.' In the same impartial tone 
the king wrote,^ on the 22nd of August, to Dr. Aronson 
to acknowledge a copy of his essay (with the motto 
Errare humanum est) replying to the objections of 
Hofrath Professor Herz and Dr. J. Valentin Miiller. 

Opinion within the profession was much divided in 
Berlin and feeling ran high. In the Hamburger Corre- 
spondent {No. 170, 1801) a " Citizen of Berlin " wrote to 
challenge the statement made in a Bremen essay, that 
"since the introduction of the new practice, 50,000 had 
been vaccinated, without a single case of injury done or 
of protection failing." As evidence of failure he gives 
particulars of a number of cases known to himself in 
Berlin. A long detailed reply was drawn up to this by 
eleven Berlin practitioners concerned in the cases, which 
were all satisfactorily excused on one plea or another.' 
The cause of cowpox took much benefit from tlie alleged 
attempt of a certain Dr. Wolff", in Berlin, an adherent of 
the old inoculation, to pass off smallpox virus, it was 
said, for cowpox, the child's parents, who were people 



' Medicin.-Chinirg. Zeiiimg, iSol, ili- 158. 
■ Ibid., 1802, i. 112. » Ibid.y 1802, i. 138. 



RESULTS OF OFFICIAL INQUIRY. 221 

bf position, having expressed a wish to have the latter 
The child at once took smallpox and died ; but 
■Wolff protested that it was vaccine which he had used, 
^and not variolous matter. 

Earlyln the year 1802, the king so far departed from 
B^is neutral attitude as to get himself and his youngest 
ftchild vaccinated. Hufeland announced the "good 
Roews" in his Journal,^ and added that the infection had 
fbeen communicated with the happiest success, as he 
Icould personally testify. A few months later, on the 7th 
I of June, the returns in response to the official circular of 
1 nth July, 1801, were abstracted and commented on in a 
report signed by the president, the decamis, and coun- 
cillors of the Ober-Collegium for Medical and Sanitary 
I Affairs.^ The return had been made by seventy-one 
1 physicians in civil practice and thirty-six regimental 
\ physicians, and it related to 7,445 vaccinations. In a 
lumber of these, "attempts of every kind" had 
been made to test the efficacy of cowpox, not only by 
inoculation of smallpox, but also by exposing the vac- 
cinated to the contagion in various ways. Four medical 
men, whose names are given, had especially distinguished 
themselves over these tests ; but the particular results 
are published from only one of the four, Dr. Kijster, of 
Conitz. He had made sixty vaccination.^, and had 
variolated everyone of them eight to ten days after ; 
not one of the sixty " took," the inoculated spot having 
shown redness and inflammation to the third, fourth, or 
fifth day only. Not more than four cases had occurred 

r, p. 6s. 



223 THE GERMAN ENDORSEMENT. 

in which evidence of protection was wanting, 
these raised the question of the genuineness of the 
lymph. The Obcr-Collegium ends its report with i 
eloquent recommendation of the Jennerian method ; at 
the least, it would protect from smallpox as well as in- 
oculation with tJie " natural " disease, and it was free 
from the objections to the latter. 

This report was made public on the 7th of June, and 
on the same day a Royal Proclamation was issued, 
recommending the general adoption of the Jennerian 
practice throughout the Prussian dominions.' It had 
not taken so many years' experience to settle the 
question as the king's letter of 27th June and the circu- 
lar of the nth July, 1801, had indicated. If there was 
a judicial temper in some quarters, there was enthusiasm 
in others. 

The course of events in Silesia affords a curious 
illustration of the hesitancy for a time on the part 
of the Prussian king and his councillors. On the 
rst of July 1801, a proclamation^ was issued from 
the Royal Prussian Kriegs- und Domainen-Kammer at 
Breslau, advising all parents throughout Silesia to 
have their children vaccinated, and strongly inculca- 
ting on all physicians and surgeons in the province the 
duty of furthering the vaccine inoculation by every 
means in their power. On the 24th of the same 
month, the Kammer at Breslau issued another pro- 
clamation amending, or rather rescinding the former, 

Hu/ilaiia's Journal, l8o2, pt. 3, p. 108. 
Midicin.-Chirur^. Zeitung. Salzburg, i8or, iii, 159, 



ENTHUSIASM AT BRESLAU. 223 

which, it is expressly said, had been issued at the special 
■instigation of the Collegium Medicurn of Brestau, A 
closer inquiry had meanwhile shown that the vaccine 
inoculation was '■ not yet commendable by the Govern- 
ment as a means of checking the natural smallpox." 
The former proclamation should be therefore amended 
as follows : '■ That the cowpox inoculation must still be 
regarded as a not infallible protection against smallpox." 
The incident means officially, perhaps, nothing more 
than that Breslau had to wait until Berlin should have 
decided ; but it is clear that there was enthusiasm for 
the new practice in influential professional circles in 
Silesia. We are enabled to look a little behind the 
scenes here. 

The leader of the movement in Breslau was a certain 
Dr. Friese, who had translated Woodviile's Reports and 
Aikin's Concise View, and had taken much pains to 
circulate De Carro's Vienna treatise. He was joined in 
the practical work of vaccinating more especially by 
seven others in the city, some of them men of position 
in official, civil and military circles. From the 23rd 
December, 1800, to the 25th of June, 1801, these eight 
had vaccinated 509 children, of whom a list was pub- 
lished,' with the name and profession or occupation ol 
the father in each case. Most of them were the children 
of well-to-do people, Friese says that these all escaped 
the smallpox that was then epidemic, although some of 
them were exposed ; he gives two or three trivial in- 
stances of exposure to the contagion, and one or two 
cases where variolation was done more as an additional 



224 



THE GERMAN ENDOKSEMENT. 



protection thaii as a test, with the curious result in one 
case that the old vaccine sores on each arm were inflamed 
anew on the thirteenth day of the variolation. There is 
ample evidence that the people in better circumstances 
were willing to try the new method ; but there is nothing 
in the writings of Friese to show that he or they had 
an intelligent acquaintance with the radical differences 
between it and the old. There was some opposition in 
Breslau, which found expression in a tract. Something 
more about the Co'wpox ; but Friese summarily disposes 
of it by the usual cry of " merely theoretical." 

Another supporter of cowpoxing in Silesia was Dr. 
Struve, of Gorlitz, the author of several popular works 
on the health of children, which were all translated into 
English. Struve makes a great point of having been 
converted from opposition to the new inoculation by the 
evidence. The reviewer of his Introduction to Vaccine 
Inoculation, in the weekly journal of the German pro- 
fession published at Salzburg, says that Struve's own 
experiences are nothing exceptional, but that, taken 
along with his variolous tests, they serve to establish 
the advantages of the great discovery. But Struve 
distinctly admits the fewness of the variolous tests 
among his two hundred vaccinations ; if he had tested 
them all, he says, it would have been but a small 
addition to the thousands of proofs already given. 
He has the vaguest notion of what cowpox is, thinks 
it is smallpox of the cow, and puts down the pustular 
eruptions, which some of the children caught, as being 
the proper eruption of cowpox, whereas it is beyond 
doubt that they were an attack of the contagious small- 
pox then raging in Gorlitz and the country around. 



A LUSATIAN AUTHORITY. 225 

Hegivesonly fivevarioloustests in his twohundred cases;' namely, 
cases zi, Z2, and 23, vaccinated on 7th February and variolated (ui 
17th March ; case 79, vaccinated on isl March and variolated in 
April ; and case 167, vaccinated on 23rd April and tested In August 
The three on I7lh March had been vaccinated with tenth-day lymph 
fromtwochildren who had ulcers on their arms for a number of weeks 
after; whether the stock from their vesicles produced the same effects 
we are not told, but as it was takcnat the tenthday, it would probably 
reproduce its ulcerous properties ; so that we should be really deal- 
ing with the variolous test as tried upon three children with suppu- 
ration going on near to where the smallpox matter was insertetL 
Of the fourth case we simply read that the variolous test was with- 
out effect. But the remaining case, No. 167, which was tested 
four months after vaccination, is given with particulars. It appeais 
that no cowpox vesicle was produced at all, although there was 
some " local and general action." Dr. Struve therefore doubted, as 
he well might, whether the vaccinal effect had been produced on the 
constitution, and on that account he variolated the chiid. As thai 
inoculation produced no smallpox, he felt sure that the cowpox pro- 
tection had really been imparted. Of course, if the child had 
been successfully variolated, or had caught the epidemic smallpox, 
it would have been said that the vaccination had failed, — as indeed 
it had failed, if the presence of a vaccine vesicle be essential to 

TliroughouC these dreary records we constantly meet 
with palpable fallacies of that kind, such as no one 
would dare to present to an assembly of ordinarilj'' 
intelligent laymen.^ 

In the important city of Frankfurt-am-Main, the 

' Anhilung zur Kenntniss und Impfting der Kuhpocken. Bres- 
lau, [go2. 

' In Dr. Struve's country of Lusatia, the popular feeling against 
vaccination is now very strong, according to the Vienna Fremdem- 
blatl; which adds the following anecdote ; A schoolmaster having 
asked, " Why was Moses hidden by his mother ? " a small pupil 
replied, " Because his mother did not want him to be vaccinated." 
Q 



226 



THE GERMAN ENDORSEMENT. 



Jennerian inoculation was taken up by no less a personT 
than tlie anatomist and surgeon von Sommerring, 
conjunction with Dr. Lehr. 1 advert to it because it ' 
was specially the variolous test that Sommerring directed 
his attention to.^ He set to work with all the precision 
which we might expect from one so thoroughly practised 
in die most rigid methods of descriptive anatomy. 

Fourieen vaccinated children were brought logether to one place,,! 
and all inoculated on the same day with smallpox before wit 
The smallpox matter was ^ken fresh from a child's pustules a 
third day of their suppurative stage, and was inserted by lancet- 1 
puncture. The children were kept under obseri'ation, and inspected I 
from time to time by impartial witnesses. By the second o 
day inflammation had arisen at the punctures in them all, and a 
papuUtr elevation could be felt ; on the fourth day all the papulesA 
had a zone of redness about half an inch around, and a little yelloH'l 
fluid at their summits ; on the fifth and sixth days eleven of theM 
fourteen cases showed the papules become pustules, lai^er ov-fl 
smaller, filled with yellow matter, the remaining three cases having'! 
aborted from the papular stage ; on the seventh day the rednesB 1 
began to decUne and the pustules to wither; and on the eighth f 
day the redness had disappeared, and the pustules become covered I 
with yellowish -brown semi-transparent crusts. No erupiioi 

This is one of the best-recorded variolous tests in the A 
whole literature of vaccination, 1 have taken it from J 
the account in the Salzburg journal, which omits to say J 
how soon after vaccination the test was applied ; and I | 
have been unable to supply the omission by reference tO; 
Sommerring's original paper; but the practice of th<^ 

' Summary of Priifung dir Schiitz-oder Kithblattern durch 
"■Gegemmp/ung tnit Kinderblattirn. Von Hofrath Sommerring u 
Dr. Lebr (Frankfurt-am- Main, iSoi, pp. 38), in Med.-ChirHyg 
Za'/itng {oT 2yd July, 1801. 



TESTa BV SdMMERRlNG. 22/ 

time was to apply the test very soon after (in the sixty 
cases of the test, which were the only ones adduced 
in the Prussian official report upon vaccination, it was 
applied on the eighth or tenth day) ; and it seems pro- 
bable that a set of children had been vaccinated to- 
gether and kept together until the test was undergone. 
The absence of the general eruption was therefore no 

- marvel ; and in eleven of the fourteen the local infection 
was complete. Not only so, but it was such a degree of 
inoculated smallpox as would have been pronounced a 

■ satisfactory protection, if the variolation had not been 
to test the antagonising power of cowpox, but had been 
an end in itself. The same medical journal which re- 
produces that test with approval had asked, only two 
years before (33rd May, 1799), when cowpox was a new 
thing : " Is it worth while adopting this novelty, seeing 
that the usual method of inoculation [with smallpox] 
is for the most part undergone so happily that the 
children hardly appear to be ill at all .' " 

Sommerring, however, was satisfied, and the doctrine 
of protection was established in Frankfurt. Certajn 
cases of alleged smallpox after vaccination were hunted 
up by Dr. Ehrmann, a rather violent opponent, although 
a man of position ; but these, or some of them, were 
accounted for by Sommerring and Lehr. Two satirical 
pieces were published in the city, making out that the 
new inoculation was being taken up byenterprising young 
doctors, in order to introduce themselves into private 
practice, or to find a means of supplanting their old- 
established but less go-ahead rivals.^ The same motive 

' Med.-Chirurg. Zeitung, 1801, ii. 399. 



THE GERMAN ENDORSEMENT. 



i 



has operated so frequently in the adoption of new medical 
fashions that it is quite credible it should have played 
a part in determining the reception of cowpoxing and 
the particular hands into which the new practice should 
falL There are other evidences from Germany that vacci- 
nation was in request among the well-to-do public. Stro- 
meyer, for example, wrote to a London correspondent 
from Hanover on the 14th of March, iSoo, that, at that 
early date, most of the Hanoverian physicians " exclaim 
against the vaccine inoculation, asking, Are people thus 
secured against the smallpox for their whole life-time ? 
Nevertheless, I have the satisfaction to see a partiality 
for it displayed by the greater part of the public."^ 
But in February, i^o[, he is able to say that the bulk of 
the profession in Hanover, including all the leading men, 
were now in favour of the Jcnncrian novelty;^ from 
which we may infer that they had found it advisable to 
supply that sort of article for which their clients showed 
a partiality. 

It is clear from the bulky handbooks of the new 
practice that quickly began to appear in Germany,* that 
the period of scrutiny was soon over. Professor Nolde, 
of Rostock, had indeed the temerity to say that a much 
more deliberate and protracted inquiry was needed, the 
evidence being insufficient ; but his reviewer in the chief 
critical organ of the profession tells him that the evi- 
dence was quite sufficient, and indeed conclusive in favour 
of protection as asserted by Jenner.* 

' Med. and Phys. Journ., iii. 474. 
' Traiti de r 1 noculalion. Lcipsic, i8oi. 

' By Buchholz, 1801 (pp. 542), and by the elder Hecker (pp. 248), 
Erfurt, ilio2. * Hufeland's AWiWA^X-, 1802. 



HESSIAN EXPERIHNCES. 229 

In other parts of Germany the new practice was 
adopted with even !ess of scrutiny and discrimination 
than in Hanover and Prussia. The apostles of cowpox 
in Hesse Darmstadt were a certain Professor Hessert, 
and a Captain Pilger, who ended by formally adopting 
the veterinary profession. They started in 1801 a 
journal for all matters relating to vaccination,' which 
admitted some hostile papers. A critic of it in Hufe- 
land's Bibliothek expresses the hope, in 1804, that a 
journal of that kind will soon be superfluous, Down to 
June, 1801, they had performed three thousand vaccina- 
tions in Hesse Darmstadt, amidst oppo.sition or indiffer- 
ence on the part of ".so-called learned physicians," but 
with a kind of patronage or approval from the sovereign 
as early as November, 1799, Hesse Cassel gave origin 
to another cowpox periodical," edited by Dr. Hunold, of 
Cassel. At Erfurt, the new practice was taken up by 
Hecker the elder, professor of surgery, who twice pub- 
lished upon it. The old smallpox inoculation, he says, 
did not make so much progress in the eighty years since 
its introduction as the jennerian inoculation with "small- 
pox of the cow" had done in two or three years.* 

Of the practice at Leipzig, Stuttgart, and other places 
there are some extant memorials, but they furnish no 
evidence so good as that already given for Hanover, 
Frankfurt, and other cities. At Meissen, near Dresden, 
the failure of the vaccinations done by Dr. Weigei,* to 

' Archivfiir Kiihpocken-Impfung. Giessen. 
' Annahnder Kuhpocken-lmpfang Bur VerbnnnHng der Blaltern. 
FiJrth. Part I., iBot, 

* Extracts in Med.-Chirurg. Zeitung, 1802, i. 274. 

* Ibid., p. 282. 



230 



THE GERMAN ENDORSEMENT. 



protect from the smallpox then epidemic, was peculiarly 1 
obvious, and was admitted, but was at the same time j 
excused with a w^nW/ which disarms criticism. These ] 
cases of failure were cases of spurious vaccinations, 
"die freilich nicht vor Kinderblattern schiitzen." The , 
freUick is inimitable, and cannot be translated. Despite 
his unfavourable experience of the epidemic, Dr. Weigel 
got favourable results by the experimental method. He 
tried thirteen of his 121 cases with variolous inoculation, 
and found them protected. 



There are hardly any details in the medical Journals 
of the time to show what scrutiny the J ennerian doc- 
trine met with in Bavaria before it was accepted ; the 
reception of it would seem to have been 011 faith alone. 
On the i6th of August, iSor, a proclamation' ' 
issued, in which the Commission for Public Health at 
Munich, on the initiative of his Serene Highness, urged 
all medical practitioners in town and country to apply \ 
themselves to the great work with true patriotic zeat I 
The new method had already been tried, it seems, with \ 
the best effects ; and parents were demanding it. The ' 
voice of experience was waxing ever louder for the g 
cause of cowpox inoculation. Children during an epi- 
demic should not be chosen for trial of its protective 
virtues. It was necessary to distinguish carefully be- 
tween true and spurious vaccine. 

At Regensburg an impulse was given to the Jenneriaa 
practice by the patronage of the palace, which made up 
part for the absence of "a good theory of the 




THE LEADERS IN VIENNA. 



231 



antagonism between cowpox and smallpox, two unlike 
diseases," to quote Schaffer, the Regensburg vaccinator.^ 
In the country near Erlangen, the cowpox was dis- 
covered, and was found to be a spontaneous affection 
unconnected with horse-grease ; its independent origin 
on the cow's teats gives occasion for the remark, that it 
is well known that Jenner's opinion of the origin of the 
malady has been long overthrown. The actual finding 
and identification of cowpox at Erlangen served in a 
vague and unreasoned way to strengthen the belief in 
Jenner." In Holstein, not only had the cowpox been 
found, but, it was alleged, also the country legend of 
its protecting from smallpox.^ 



In Vienna the movement was vigorously started by 
two men, De Carro and Careno, one if not both of them 
graduates of Edinburgh, who must be classed with the 
pushing practitioners spoken of in the Frankfurt satires 
on cowpoxing, the men who are on the outlook to float 
themselves into reputation and practice on the wave of 
some new fashion. Careno had published some ten 
years before a popular catechism of inoculation, which 
had reached a third edition. Of his enterprise in the 
new business the following is an example: — 

It happened that Dr. Schulz, of Berlin, body physi- 
cian to Prince Ferdinand, had sent to the Czar of Russia 
a copy of an essay that he had published on the cow- 

' Biitrag zu einer Theorie tier Englischen Pocken-Imffung. 
Regensburg, 1801, 

* Lavater, " Ueber die Milch blattem," a lecture at Zurich, ist 
December, 1800. 

• Hufeland's Bibliothsk, 1801. 



233 



THE GERMAN ENDORSEMENT. 



1 



pox. He received in reply a letter from the Cz 
stating tliat the Russian trials of cowpo.x up to that 
time had not turned out quite so well as was to be 
desired, and that any physician who could and would 
practice the protective inoculation with success might 
reckon on the applause of the public as well as the 
favour of the Czar. Upon that hint, Dr. Schuiz re- 
paired to St. Petersburg, and came back loaded with i 
honours, and enriched with two thousand gold ducats. 
given him by the Czar. Meanwhile Careno had heard 
of the Czar's invitation to any physician who could 
make the cowpox charm eiTectivc, and had seat his 
writings also. He did not make such good business out 
of it as Schuiz, but he received a letter from the Czar, 
thanking him for his books, and the gift of a ring set 
with brilliants. 

The practical trial of cowpox at Vienna was one of 
the earliest made abroad. The criticism, also, of Jenner's 
/n^a/Vy was begun earlier, and was done far better in the 
weekly medical journal published at Salzburg^ than in 
any other journal, English or foreign. Perhaps Ingen- 
houszhad a hand in this. A reviewer of the Inquiry, 14th 
January, 1799, remarks upon the fact that cows' small- 
pox (Kuhblattern) is claimed in Jenner's title-page as 
a new disease ("discovered " is Jenner's word) ; the fact 
that it was only the name varioliE vaccina which was 
new had escaped the reviewer. He points out that only 
three of Jenner's vaccinations had been tested with 
smallpox, and that three was too small a number. 



' Med.-Ckirurg. Zeitiing, 1B02, i. , 
' Medicinisch-Chirurgische Zeitut 



CRITICISMS OF THE MEDICAL PRESS. 233 

The hopes built on such reasoning might be illusory ; 
there were analogous cases, he says, under the old 
practice, in which children supposed to have been 
successfully variolated had yet caught smallpox in an 
epidemic. He counsels deliberate inquiry and close 
scrutiny : " that will bring more credit to us Germans 
than if we join the English forthwith in beating the big 
drum." In the number for 24th October, another pen 
reviews Woodville's Reports, a book which was unques- 
tionably a more workmanlike performance than anything 
of Jenner's. The reviewer of Woodville thinks that 
readers of the book can hardly fail to carry away the 
impression that cowpoxing was destined to replace 
smallpox inoculation ; he discovers, also, that there is 
some sort of help in it to the doctrine of animal poisons, 
and an important contribution to pathogenesis. In the 
very same number, a less friendly hand reviews Pear- 
son's Inquiry, and concludes that much expeiience is 
still needed before we can accept the prophylaxis of 
cowpox as correct in principle, and give the old variolous 
inoculation its dismissal. The next number contains a 
guarded review of Jenner's Furtlier Observations, in which 
it is remarked with obvious irony that " all his experi- 
ences have so fully convinced him of the truth of his 
original positions [including horse-grease], that he holds 
it superfluous to return one syllable of answer to those 
who are of a difi'ereiit way of thinking." 

The first reference to the practical trial of cowpox at 
Vienna is on the 23rd of May, 1799, when " C." writes 
to give an account of experiments by Dr. F. and Dr. 
De C. The writer doubts whether the new protective 
is really milder than the variolous inoculation as then 



2H 



THE GERMAN ENDORSEMENT. 



practised, and whether it really does protect. De Carro 
himself did, in fact, see enough of cowpox ulceration on 
the arms to have made him doubt the mildness of the 
new protective, if not to have shown him what kind of 
pox it really was. He saw, also, enough of failure to 
protect from smallpox to have satisfied him that the one 
kind of pox was altogether irrelevant to the other, The 
greatest breakdown with De Carro's lymph, comparable 
to the fiasco of Oebisfelde, was near Geneva, the lymph 
being spurious because it had passed through a vaccini- 
fer who had had an attack of smallpox five-and-thirty 
years before.^ He had other experiences of which we 
do not knoiv the details, but only the conclusions. He 
discovered that the cowpox which forms a large scab, 
remaining until the 29th day, is spurious ; this kind does 
not protect from smallpox. He allowed himself to 
make as many spurious varieties as he pleased. 

There were two formal variolous testings of cowpox 
on a considerable scale in Vienna, One was made in 
the presence of a good many witnesses on the 14th of 
July, 1801, by Drs. Portenschlag and Helm (under the 
instigation of De Carro), in the garden of Count Schon- 
born, upon twenty-one children who had been cowpoxed 
(all but one) in March, April, or May preceding. The 
progress of the inoculation is not described; what was 

I done was to bring the children back for inspection on 
the 23rd July, or tenth day, and on the 29th July, or 
sixteenth day, those on the latter date being perhaps 
; 



Hochst merkwurdige Erfahrung iiber die Entkraftung des 
KuhpoeUengifte dutch die vorhergegangene Menschenpocken- 
krankheit," By Dr. De Carro. Hufdand's Journal, x. pt. 4. p. 129, 




THE VARIOLOUS TEST AT VIENNA. 235 



I some who did not present themselves on the earUer. 
When the children were seen nine or fifteen days after 

;ir variolation, none of them were labouring under 
smallpox eruption, and only three of the twenty-one 
had traces of local suppuration, the inoculated spots 
having "completely dried up" in the remaining eigh- 
teen,' That, of course, is peculiarly disappointing as a 
record of what really happened. Was there not as 
much effect of the variolation in each case as the 
practice of the time was calculated to produce? Did 
not the same medical Journal which records these experi- 
ments say on the 23rd of May, 1799, that variolation 
" is mostly so happily undergone that the children 
scarcely appear to be ill " ? 

The other formal trial at Vienna was made on behalf 
of the Government medical department at the Allgemeine 
Krankenhaus on the 12th of November, 1801, upon four- 
teen children who had been vaccinated all together on 
the ist of September. The matter for their variolation 
was taken from the pustules of a child in the natural 
smallpox. They remained a fortnight in the hospital, and 
were daily inspected by the Director himself; "but in 
not one of them did the slightest trace of smallpox in- 
fection declare itself," This means that there was, at all 
events, no general eruption, although there may have 
been, and almost certainly was, the local pustule. 
Hofrath Dr. Frank reported the result of this trial ' to 
the Government, which, in March following (1S02), issued 



' Mid.-Ckirurg. Zeitung, i3oi, iii. 337. 

' Med.-Chirurg. Ztilung, 1802, i. 159 ; also a report of the s; 
by Careno to the French vaccine commission, ibid., p, 227. 



23e 



THE GERMAN ENDORSEMENT. 



a proclamation recommending the general use of vaccine 
to ward off smallpox, " The prejudices which had at 
first opposed it," says the biographer Baron,' " were thus 
effectually overthrown, and a series of regulations were 
established which soon rendered it general in Vienna ; 
and in no long time smallpox was almost banished from 
that capital." 

From other parts of the Austrian empire we receive 
no evidence of scrutiny or scepticism. From Prague 
the first report* is that Dr. fi. Keilly had vaccinated 
twenty persons by the month of June, i8oi, and had 
publicly declared that he would answer for it that every 
one vaccinated by him (6. Keilly) would never be 
attacked by smallpox. 

The enthusiasm for the new kind of protective is well 
shown in the projects that were at once started for ex- 
tending it to other diseases besides smallpox. De Carro 
found evidence at Constantinople that cowpox was an 
antidote also to the plague ; six thousand had been 
cowpoxed in that city and not one of them had taken 
the plague ; there were villages near the capital where 
true cowpox of the teats occurred, and it was the unani- 

tmous testimony of the residents that neither plague nor 
smallpox ever entered them.* Struvc believed that vac- 
like 
just 
sho 



* Med.-Chinirg. Zeiittng, June, 1801. 

^Journal de Mid., vii. 355 ; Jcniier (in Baron, ii. 13) did 
like this extension of the area of cowpox prophylaxis : " I 
just drop a hint — the vaccine disease, in my opinion, is not a 
e of the smallpox, but the smallpox ilself. . . . Now, 
should ever be discovered that the plague is a variety of s 
milder disease," etc 



PROTECTION FROM OTHER DISEASES. 237 

cination moderated the severity of scarlet fever, if it did 
not prevent the attack ; and Careno found reason to 
adopt the same opinion. Various sanguine expectations 
of the same l<ind were floating about also in England, 
but the only practice that was seriously tried was to 
vaccinate puppies against the distemper. It need hardly 
be said that the cowpoxing turned out to be purely 
irrelevant.^ But there was one significant attempt to 
extend the area of vaccine usefulness which demands a 
more particular notice. 

If cowpox couid ward off human smallpox, it would 
have been a very strange thing if it did not also serve to 
protect the sheep from the variolous contagion to which 
they were peculiarly exposed in some parts of the 
Continent, The sheep-pox is a true smallpox of sheep ; 
it is variola oviua, properly so called in respect of its 
being a highly contagious pustular skin-complaint, indis- 
tinguishable in almost any point from the smallpox of 
man. The cowpox was no sooner given out as a means 
of anticipating the natural or epidemic incidence of 
human smallpox than it was tried for the protection 
of the flock-master from his heavy periodical losses. 
Viborg, the Copenhagen veterinary authority, was very 
busy in those years with all questions relating to small- 
pox or other poxes of animals, and from him I take the 
following :^- 

' Jenner vaccinated the king's staghounds in June, 1801 (Baron, 
i. 444). Eiglit years after, he published in the Med.-Chirurg. Trans. 
(vol, i,) a paper on the dog-distemper, of no value clinically or 
pathologically, and omitting all reference to v 

' Abstract in Med. and Phys. Joum., \\ 



23S 



THE GEKMAN ENDORSEMENT. 



"It is known, from the observations of French physi- 
cians, that cowpox defends the sheep against the sheep- 
pox infection, in the same manner as it secures men 
from the smallpox ; which seems evidently to prove the 
Identity of the cowpox and the sheep-pox." Vibor^ 
ought to have known that the identity of cowpox and 
sheep-pox was not to be proved either by the verbal 
jingle of the names or by a piece of speculative reason- 
ing. Viborg, like all veterinarians, doubtless prided 
himself upon being a practical man ; but his manner 
of proving the identity of cowpo.x and sheep-pox might 
have been learned of the Schoolmen. It is clear that 
he accepts the French doctrine of the prophylaxis qf 
cowpox against variola ovina; and why should he not, if 
cowpox wards off variola humanaf As a matter of fact, 
vaccine inoculation does not ivard off the smallpox 
of sheep, although it "takes" in them just as in man. It 
has turned out a commercial failure ; and, as flock- 
masters are in a position to take a thoroughly business- 
like view of the matter, they have not scrupled to 
abandon the practice. The evidence of its failure will 
be referred to in the chapter on vaccination in Italy. 




CHAPTER X. 

RECEPTION OF COWPOX IN FRANCE. 

FOR reasons both inherent in the national character 
and depending on the circumstances of the time, 
the reception of cowpox inoculation in France could 
not have been a mere echo of the verdict of superior 
persons in England or of professors in Germany. There 
is something in the best French writings on the new in- 
oculation, whether in favour of it or adverse to it, which 
makes them at once more readable and more worthy of 
serious attention. The verdict of France having been 
just as decidedly favourable as that of England and of 
Germany, it becomes a matter of fresh interest to under- 
stand how this great nation, still breathing a spirit 
of scrutiny and rationalism, should have been hood- 
winked into adopting a medical dogma which had as 
little scientific basis in the pages of Jenner as it had in 
the foolish heads of some Gloucestershire old women. 

It is in the reception of Jenner's project by the French 
that we see most clearly the insidious working of his 
disingenuous title-page. The French knew nothing of 
cowpox at home, or at least had no corresponding 
word in their language ; from the very first they took 
Jenner's trumped-up name of variolcs vaccina in good 



240 



RECEPTION OF COWPOX IN FRANCE. 



faith, and constantly spoUe of cowpox as petite v^role des 
vaches,ov smallpox of the cow, until the ingenious ab- 
breviation of " vaccine" came into general currency. 
Thus, the translation of Woodville's Reports by Aubert 
in 1800, before the practice had begun in France, bore 
the title Cowpox, ou la Petite Virole des Vaches, substitute 
d lapettte virole. Even the most acute of all the critics 
that vaccination called forth, in France or elsewhere, in 
those years, Dr. Jean Verdicr, did not quite fathom the 
enormity of Jenner's great title-page trick, Verdier, a 
man of varied fortunes, who had made his mark five- 
and-thirty years before by his medico-legal treatises, pub- 
lished in 1801 a sixteen-page pamphlet on vaccination,' 
which the wearied traveller through dusty files of journals 
and essays comes upon as an oasis in the desert. 

One sentence of it only concerns us at present : " The 
country people in England, as well as the doctors, have 
represented the vaccine disease as being the smallpox it- 
self That is a good thing for inspiring confidence ; but, 
unfortunately, the two diseases have nothing in common, 
and so the ground of protection falls through {et voilA 
le fondement du prcservatif ecroulf)" But, to do the farmers 
and milkers in the dairy districts the justice that is due 
to them, they never represented cowpox to be anything 
but the pox-sores which they knew by painful experi- 
ence. There was, indeed, the foolish legend, more at 
home in the empty heads of idle gossips than among 
those who knew by experience what the cowpox was, 
that the affected milkers carried a charm against the 



' Tableaux analytiques H critiques lie la Vaccine et de la Vacci- 
nation. Paris, Ad ix. Germinal 



jenner's trick not found out. 241 

smallpox, just as the plant hound's-tongue gave to those 
who carried it on their persons a protection against a 
mad dog ; but there is not a particle of evidence that the 
rustic ideas about cowpox identified it in its nature with 
smallpox. On the contrary, the milkers would associate 
it then, as they are said to do now. in some vague way 
with the " bad disorder," and be disposed to be somewhat 
shame-faced over it. It was jenner, and Jenner aione, 
who called the cowpox "smallpox of the cow," having in- 
sidiously placed the name in Latin on the forefront of his 
Inquiry, and then carefully abstained in the preface and 
text from over once saying that he had given the disease 
of the cows and milkers a new name, or why he had given 
it a new name. Even so trenchant a critic as Verdier 
was hardly prepared to find that an Englishman, whose 
designation of F.R.S. proclaimed him to be of academi- 
cal rank, should be wanting in the rudiments of common 
candour. The trick of the title-page had relatively more 
effect in France than elsewhere ; it implanted an illusory 
idea as to the nature of cowpox, which at once found 
expression in the French name, and became the more 
fixed in the minds of the French profession of medicine 
by reason of their having few or none of those first-hand 
experiences of the shocking nature of cowpox in the 
cow which the English were not wanting in. 

There was another reason why inoculation with small- 
pox of the cow should prepossess the French mind favour- 
ably. The original inoculation with human smallpox 
had been thoroughly discredited in France on account 
of its palpable disadvantages, and had fallen into almost 
total neglect. It began to revive somewhat in the years 
immediately preceding the appearance of Jenner on the 



242 



RECEPTION OF COWPOX IN FRANCE. 



scene ; but even Goetz, the Paris variolator of most ' 
repute about 1798, averaged hardly more than a hundred 
cases in the year; and in the public services inoculation 
was not practised except among the pupils of the Ecole 
Militaire, "where Gatti did not, indeed, have brilliant 
success."^ The rival plan of checking the heavy mortality 
from smallpox among infants and children, by rigorous 
isolation of the sick, which appears to have been taken up 
by Junckerand others in Germany, and found an Eng- 
lish advocate in Haygarth, was in those years seriously 
entertained in France, But the petite verole des vadtes 
was admittedly free from the great objection to in- 
oculated petite verole itself, however unaccountable the 
non-contagiousness of the former might be. The new 
inoculation had therefore a clear field in France ; it 
seemed to promise all the easiness of the old inoculation 
without the drawback of contagiousness, while, on the 
other hand, the arduous nature of the isolation-plan, 
although never realized, was so clearly foreseen as to 
make any safe alternative welcome. 

While the Paris physicians were thus favourably 
disposed towards the Jennerian inoculation, they had 
no intention of formally accepting it and recommending 
it without rigid scrutiny. A public subscription was 
raised, and a vaccine station opened in the month 
Flo real, an viii. (1800), with the following objects: "to ' 
repeat the experiences of the English ; to seek for new j 
experience ; to add to the number of variolous tests ; 
to investigate the truth of all the rumours current as to 




comit£ central de vaccine. 



the alleged disastrous effects of vaccine." These in- 
quiries were conducted by a Comit^ Central de Vaccine, 
composed of twelve medical men of character and 
repute, with Thouret as chairman. Among the other 
members were Guillotin, who had played a part in the 
Revolution, Leroux, professor at the Ecole de Medecine 
(one of the editors of the Journal de Medecine, which 
began to appear in iSoi, and became the organ of the 
vaccinists), and Salmade, who had published a treatise 
advocating the re-introduction of the smallpox inocu- 
lation in the very year (1798) in which Jenner's Inquiry 
appeared. The Comite Central were three years in 
issuing their final report (1803), which was a bulky, 
prolix document that few were likely to read. But 
they published a good many interim reports in the 
journals,^ which practically committed them to the new 
practice from the outset. 

On 28 Vendemiaire, an ix., they published a few 
variolous tests ^ which, as we shall see, were ambiguous 
if not altogether irrelevant ; and although they pro- 
fessed to be "far from regarding the evidence as suffi- 
cient," yet they had observed a protective action of 
vaccine in those whom they had " re-inoculated " with 
smallpox. A few months later (29 Pluviose, an ix.) 
they announced that grave mistakes had been made 
in vaccinating ; there was a kind of vaccine, non-pro- 
tective from smallpox, which Is known as spurious 
vaccine {fausse vaccine)? On 21 Germinal, the pro- 
tective power of vaccine, "if not demonstrated, is on 



' Monileur, Journal de Paris, and Journal de Midecinel 
' Joum. de Mid., i. {1801), p. 254. = Ibid., ii. 27. 



244 



KECEPTION OF COWPOX IN FRA^■CE. 



the point of being so." ^ On 3 Prairial, they return to' 
the subject of spurious vaccine: "The Committee, 
in several of the notes which it has published, has 
been careful to premise that, under certain circum- 
stances, the vaccine inoculation may not follow its 
regular course in certain subjects, and may give rise to 
a false vaccine which affords no protection from small- 
pox." They then refer to the notorious cases near 
Geneva, and to "cases that have occurred quite recently 
under our own eyes in one of the villages near Paris." ' 

The strongest report is that of 30 Brumaire, an x.* 
A long and uniform experience had convinced the 
Committee that the dangers of vaccine were few. But 
it remained to assure themselves of its protective power, 
and more particularly to find out if the protection lasted 
more than a year. Accordingly they invited a large 
number of representative physicians and surgeons in 
Paris to witness the variolous test at four sittings upon 
102 infants, some of whom had been vaccinated a year 
before and a few of them eighteen months before. The 
results are certified by all the invited witnesses; who 
included eight members of the Institute, fourteen phy- 
sicians of the ci-deva7it Faculty of Medicine, six pro- 
fessors of the Ecole de M^decine, five members of the 
Army Board of Health; four members of the Society 
de I'Ecole de M^decine (Bichat, Dupuytren, Auvity, 
and Alibert), and thirteen others. This, of course, was 
a great demonstration ; but it only amounted to an 
attestation that inoculated smallpox produced no effect 



■ Journ. de MM., i 
' ibid., iii. 303. 



162. 



■ Ibid., ii. 307. 



DR. JOSEPH VAUME. 24S 

in most of the infants, and merely the local pustule in 
the rest. The Committee, however, in their next report, 
concluded that the results of the trial on the 102 infants 
ought to dissipate all uncertainty as to the duration of 
the vaccine protective power. 

Before remarking on the nature of the evidence which, 
in all good faith, served to convince the Comite Central, 
we may notice the criticisms that reached tliem from 
without, at successive stages of their inquiry. Their 
most trenchant critic was Verdier, who appeared only 
once in the field ; the other considerable antagonist was 
Dr. Joseph Vaume, a retired surgeon-major, who issued 
three pamphlets.' The Committee replied to Vaume's 
several objections in the newspapers of the day, making 
him speak, as Vaume complained, in language of their 
own choosing ; his own rejoinders were refused admis- 
sion by editors, and at the end of his third pamphlet 
he explains that, "whether they answer me or whether 
they keep silence, this is the last time that I address 
the public on these chim£eras. I have brought the 
dangers of them under notice ; my task is fulfilled." 

Vaume's objections were partly of the dialectical sort, 
which the Committee had, of course no patience with, 
and made no answer to, and partly founded on the 
results of vaccination as observed by himself. He pro- 
duced affidavits of several disasters and deaths from 
vaccine in Paris, which the Committee met by denials 



'(1) Reflexions sur la ncuvells Melhode dH/iociiler la petite 
Virole avec le Virus dts Vaches, Paris, An viii. ; (z) Les Daiigerx 
de III Vaccine, An ix. Germinal ; (3) NouvelUs Preuves des Dangers 
de la Vaccine, An ix. Prairial. 



246 



RECEPTION OF COWPOX 1 



or explanations. He scrutinized the variolous tests, 
pointing out that the very infant whose vaccine vesicles 
were selected from among those of thirty others for the 
purpose of being sketched and engraved as typical had 
well-marked variolous pustules, and fever on the eighth 
day, when it was tested three months after. He insisted 
that no conclusion could be drawn from the negative 
results of a variolous test unless a sufficient interval, a 
year at least, had elapsed before trying it; and he asked 
leave to apply the variolous test himself. 

It would take many years of common experience, he 
said, to prove the alleged protective power of cowpox. 
As to the plea of spurious vaccine, politeness hardly 
allowed him to speak plainly : " Those who do not know 
your morality," he writes to the Committee, "might 
believe that this spurious vaccine is nothing but a sub- 
terfuge. I am far from entertaining that idea of the 
respectable members who compose the committee."' 
was a matter of surprise to him that, in an hour wheri 
miracles were discredited in France, they should 
taking seriously this miraculous virtue of the cows 
a single district of England to preserve the whole 
human race from one of the greatest of its scourges. 
Do not forget, he exclaims, that this pretended specific 
has taken its rise in a country which has been fertile in 
fantastic projects. Medical men in England have 
leaning towards charlatanism and system-making ; they 
have already led us astray with their project of rejuve- 
nescence by transfusion of blood, with their nitric acid 
and muriatic acid as infallible remedies for syphilis. 



VERDIER'S CRlTICrS^^. 247 

To-day it is a disease of their cows that they wojld 
inoculate upon us. 

Dr. Vaume delivered his mind, and retired from the 
unequal contest. Dr. Verdicr's arrows of criticism were 
not less ineffectual against the stolid appeals to experi- 
ment and future experience. The reception accorded to 
Jenner, he begins, had been as brilliant as that given to 
the most celebrated innovators ; still, his friends complain 
bitterly of being contradicted, and they denounce every 
opponent as an enemy of the truth. It was every one's 
duty to be on guard against enthusiasm and authority 
touching a matter which had to conform entirely to the 
general principles of medicine, or to the same reasoned 
experience upon which those principles rested. The 
vaccinists appeal to experience, and set aside all objec- 
tions founded on the unhkeness of cowpox to smallpox. 
We are to be made invulnerable by vacci;ie as Achilles 
was made invulnerable by being bathed in the waters of 
the Styx. The prophylaxis by cowpox is a contradic- 
tion of the received doctrine of protection by inoculating 
the smallpox. It is in vain to appeal to experience 
against established principles ; for true principles are 
the result of the experience of all ages, and become the 
touchstone of each successive empirical innovation. 

You have hastily taken this on trust, he continues, 
from the English, who are more eager for medical 
novelties than any other nation ; their reports are 
defective, unfaithful, often disfigured, and so drawn up 
as to serve only the glory of vaccine. Jenner's doctrine 
is " un systeme romanesque," which the natural course 
of things has already disavowed in its most considerable 
part [horse -grease] ; he deals merely in conjectures, 



248 



RECErxiON OF COWI'OX IN FRANCE. 



most of which arc refuted by his own data, although he 
erects them into indisputable axioms. In one place he 
depicts cowpox as a very grave malady, and In another 
place tells us that it hardly deserves to be reckoned a 
disease at all. Everywhere there is inexactitude, vague- 
ness, and palpable contradiction. To prove protection, 
cases are adduced by the thousand, but few details are 
ever given. We have more assurances than observa- 
tions. The variolous tests are not reported with 
sufficient detail, and what little is said about them 
indicates a heedlessness which is not compatible with 
the scrupulous exactitude of true observers. All failures 
are ascribed to spuriousncss of the vaccine, although it 
had come from the same source as matter counted 
genuine. If smallpox bcfals the vaccinated, the germs 
of it had been received before. If a fever follows the 
variolous test, it is not the fever of smallpox, but a fever 
of irritation. The after-effects of the cowpox virus 
could not be learned by keeping the children under 
observation only a few days. 

If it be a virus, as you say, then it must change the 
whole mass of the humours. It is an unprecedented 
piece of foolhardiness not to follow up its after-effects ; 
we know that it invades the body by the lymphatics, and 
that it has no grand dcpuratory crisis for its elimination j 
it may linger long; and what slow effects, what ravages, 
may it not produce with the lapse of time? It may lead 
to a degradation of the national temperament, just as a 
general inoculation with syphilitic virus would do. He 
does not question the merits of the Comitc Central ; but 
they are mistaken in seeking merely to be propagan- 
dists ; they ought also to verify. Every case should be 



A WARNING AGAINST ENTHUSIASM. 249 

done under their own eyes, and every one should be 
tested afterwards by able variolators, A complete 
record should be given of all the after-effects of vaccine, 
cutaneous, lymphatic and other, and of all cases where 
smallpox has followed vaccination. Lastly, there should 
be public conferences, where the new project might be 
discussed with as little of jealousy as of enthusiasm. 

The most obnoxious part of Verdier's criticism was 
his appeal to scientific method. He entitled his 
pamphlet Tableaux Analytiqties el Critiques, and boldly 
asserted that the whole movement in favour of cow- 
poxing had been characterized by disregard of the 
analytic method of Bacon, Locke, and CondiUac. There 
had been numerous instances before that, he said, of 
credulity being encouraged by medical men of the first 
rank. Enthusiasm could always be got up for some 
doctrine and practice which promised great benefits 
with little trouble, which called for no reflection, and 
secretly fostered the blind workings of cupidity. On 
the other hand, let any one announce the most valuable 
discovery, based upon natural laws, but flouting men's 
prejudices and demanding close study to apprehend it, 
as well as much work and expense to give effect to it — 
such an one will be met by contradiction, calumny, and 
persecution. 

This line of remark, which all who know the history 
of medicine will recognise to be sufficiently just, called 
forth a reply from Marescheau, a physician of the 
Montpellier school, which the Comite Central thought 
so well of as to publish.' The Montpellier doctor, who 



250 



RECEPTION OF COWPOX IN FRANCE. 



had some reason for asserting the philosophical character 
of medical writings in so far as his own school was con- 
cerned, challenged the accusation of Verdier, that the 
method of Bacon, Locke, and Condillac had been 
neglected by the advocates of vaccine. That is to 
accuse, he replies, those who are really the disciples of 
these great men, the professors of clinical medicine in 
the schools of Vienna, London, Paris and Montpeliier, of 
having all at once forgotten or neglected a method 
which has been long familiar to them. Jeimer himself 
had followed the analytic method, he had taken up the 
question from every point of view, he had done all that 
the most severe analyst should do. 

This, of course, is the mythical Jenner so often held 
up to our admiration in this country. Verdier, who 
seems to have read Jenner's writings at first hand, had 
found out the crudities, contradictions, and absurdities 
with which they abound. 

But the Montpeliier defender had clearly not given 
himself so much trouble ; in the enthusiasm of the hour, 
he had taken without scrutiny the romantic story which 
Jenner in iSoi had given in his " concise history " of the 
origin of cowpoxing, as if it had been historical truth. 
That brief narrative of years of thought and toil, of 
difficulties encountered and manfully surmounted, is the 
grand source of all the nonsense which men, known for 
their ability, rectitude, and even erudition, have written 
about Jenner's "caution, accuracy, fairness and modesty."' 
It is impossible for any one of average intelligence or 



k 



' Choulant, "Ed. Jet 



n Zeilge)wssen. Leipzig, 1839. 



THE VARIOLOUS TEST IN PARIS. 2$ I 

acuteness to study the Inquiry and the Further Observa- 
tions, and apply to them such terms as these. 

Vaume and Verdier can hardly have made much im- 
pression upon public and professional opinion in Paris ; 
they had to depend upon their pamphlets, whereas the 
supporters of Jenner had the press, lay and medical, open 
to them.i Moreover, Vaume and Verdier, although not 
perhaps variolators themselves, had a certain tenderness 
for what they considered the legitimate kind of protective 
inoculation ; and, like the anti-vaccinists in England, 
Vaume. at least, did not see, or shrank from dwelling 
upon, the radical fallacy of the variolous test. It was 
the variolous test that appealed most strongly to the 
imaginations of all, and that gained for vaccination an 
a.ssent which was given quite honestly according to the 
stating of the case, or according as the premisses were 
apprehended. In two former chapters I have pointed out 
that variolation in those years had come to be the mere 
shadow of its old self, and that the operation when 
resorted to for testing the protective power of cowpox 
often gave a result which would have been thought satis- 
factory if variolation had been the end itself and not the 
test of a rival protective. It was the irony of the situa- 
tion that the most resolute opponents of vaccination were 
precluded by their own commitments from attacking it 
on its most specious and at the same time its weakest 
side. We have now to make this clear with special 
reference to the acceptance of cowpoxing in France. 

One of the Comite Central de Vaccine, whose name 
is appended to all the interim reports, was Salmade, who 



2S2 



RECEPTION Of COWPOX IN FRANCE. 



had published his practical treatise on Variolous Inocula-F 
tion ' only two years before he joined the Vaccine Com- ] 
mittee. It was he who applied the variolous test in 
some, if not in all or most, of the cases that were publicly 
tried. The mode of variolation described in his book 
is the English or Suttonian method of the period ; he j 
names two French inoculators who had lately gone to 
England to learn how to inoculate large numbers at j 
once, with a view to the revival of the practice in France i 
He does not quite adopt the arm-to-arm plan of vario- I 
lating which had been used by Gatti, was the farthest J 
development of the Suttonian imposture, and was the 
plan that Jenner insidiously recommended to his readers 
when the variolous test of cowpox was to be tried. He 
says there are physicians who "think they have observed 
that when the variolous pus for inoculation is taken 
always from inoculated arms through a succession of 
cases, the smallpox becomes at length weakened to the 
point of nullity, so that the later inoculations produce 
no effect."* The grand success of Sutton, he tells us, 
was ascribed by Chandler to the fact that he used the J 
crude moisture from a case of inoculated smallpox at 4 I 
stage prior to the eruptive fever, and therefore from the J 
local pustule — the very thing which Jenner himself did J 
in his testing experiment for cowpox, and advised all. I 
others to do. Salmade knew well the significance ofl 
that practice; for himself, however, he gives it as "n 
prudent" to take the matter for inoculation from a case I 
of the natural smallpox, of the discrete or mild type : 
probably " more prudent " because the other mode-| 



AN OLD PRECAUTION OVERLOOK EU. 253 

night produce nothing at all. He is, however, quite 
Suttonian in spirit ; " The best, the most fortunate small- 
pox is that in which tJiere are feiv pustules, or even 
none."^ That was the teaching enforced by Goetz, tiie 
best reputed Paris variolator of his time. " A grand 
principle," he says elsewliere, "is that tlie presence of 
pustules {boiitons) is not necessary to the manifestation 
of smallpox. The appearance of the fever after inocula- 
tion is the one essential thing so as to be certain that 
this operation has had the effect of communicating the 
smallpox." Only the most minute quantity of variolous 
virus was required — not more than the point of a lancet 
would take up.^ 

One precaution dwelt upon by Salmade in his direc- 
tions for inoculation (1798) was singularly ignored, 
when the variolation was done as a test, at least in the 
earlier of the Paris trials. It is a precaution that was 
originally stated by Heberden, in the following words 
quoted with approval by Woodville^ in 1796, but dis- 
regarded by him also in his tests of the validity of 
cowpox at the Inoculation Hospital in 1799 : " It seems 
a reasonable practice to take some care, at the time 
of his receiving the infection of the smallpocks, that 
the person should be as free as may be from any other 
distemper ; lest nature should be hindered in producing, 
maturating, or rightly discharging them," 

Salmade's version of the law thus stated by Heberden 
is as follows ; * "It sometimes happens that the patient, 

' L-C; P- 55- ° L-C; P- 59- 

' History of the Inoculation of the Smallpox in Great Britain. 
Lond., 1796, p. 337. 
' i,c., p, 157. 1798 {before he knew of cowpox). 



2S4 



RECEPTION OF COWPOX IN FRANCE. 



at the moment when he is inoculated, finds himself at- 
tacked by some principle of disease alien to the small- 
pox ; if that morbific principle should be in greater 1 
abundance than the variolous virus, or more dispc 
than it to coction, nature will occupy herself in the first 
instance with the malady pre-existing at the time of in- 
oculation ; the effect of the latter operation is accordingly 
suspended until after the termination of the first ailment, 
and the smallpox does not declare itself until later." 
More probably the smallpox will not declare itself at ' 
all as the sequel of an inoculated virus, but will abort 
there and then with the drying up of the local pustule. 

Now the cowpox, on the showing of the vaccinists 
themselves, was such a pre-occupying disease ; it was a 
considerable lesion of the skin at the very spot where 
the variolous virus was to be applied in the way of a 
test, it was an aflection of the absorbent glands, and a 
brief constitutional disturbance. What are we to say, 
then, of that German, specially commended for his zeal ' 
in the testing business, and alone quoted by the Berlin 
Ober-Collegium, who variolated sixty persons from the , 
eighth to the tenth day after they were vaccinated .' 
Moreover, in these early days, in Paris as well as else- 1 
where, the vaccine sores were apt to keep active under I 
the scab beyond the average period. Let us now take 
the particular evidence of Dr. Voisin,' who introduced 
vaccination at Versailles, and is a better than average 
instance of the scientific qualities of the first vaccinists. 

Dr. Voisin is very severe on mere a /rwr/* objections; 
they have long since been banished, he says, from medi- 



EXrERIENCE AT VERSAILLES. 255 

cine ; it is by facts alone, by observations and experi- 
ments, that we can either establish or overthrow the 
utility of vaccination as a substitute for variolous in- 
oculation. He had himself practised the latter mode 
for fifteen years, and would welcome something in place 
of it. He had done 218 vaccinations. The crusts often 
remained on the arms until the 30th, 40th, and even 
45th day (which means suppuration underneath). His 
variolous tests were confined to seven children in the 
Hospice Civil. They were done in the presence of 
witnesses, some time within the first four months of his 
vaccine practice, but how long after vaccination in each 
case we are not told, although we are told much else. 
The variolous matter was taken from a case of natural 
smallpox in fall suppuration, and was inserted by lancet- 
puncture at a spot (on the thigh or other arm) remote 
from the vaccine. Inspected on the ninth day, four of 
the seven had the spots dried up and all traces gone, two 
had variolous pustules, and one had a red spot without 
elevation : on the eleventh day, one of the pustular cases 
had progressed to farther suppuration and to efflores- 
cence around ; on the thirteenth day, the suppuration 
had dried up. 

Such is Dr. Voisin's experimental record. His ex- 
perience, on the other hand, gave him twelve cases of 
natural epidemic smallpox among his vaccinated chil- 
dren, but these were all concurrent with and not subse- 
quent to the vaccine. In others who had eruptions 
subsequent to vaccine, the eruptions were more "like 
those known commonly s.?, petite v^role volante." Three 
of his vaccinations turned out to be spurious, bat why 
spurious he does not say. One cannot help thinking 



256 



RECEPTION OF COWPOX IN FRANCE. 



that a little less of vapouring about experiment and e 
perience, and a little more scrutiny of the premisses of- I 
the whole matter, and of the several notions and pro- 
positions contained within them, would have made him | 
a more competent judge. 

The variolous test was applied in Paris by Dr. Colon, 
with a very neat result ; but for some reason the Society I 
dc Medecine, before whom his report was read, declined ■ 
to publish it.^ Dr. Colon was really the pioneer of vac- 
cination in Paris, and not different from other vaccina- 
tors, except that he made no pretensions to be a dis- 
interested friend of mankind, but a man of business ; he 
was constantly denounced, however, by the Comit^ I 
Central, and by the academical physicians generally, as 
a charlatan. 

He tested forty-nine children with matter from a 
child in the tenth day of a copious smallpox eruption. 
Forty-seven of these had been vaccinated successfully 
at odd times during the previous twelve months, one i 
had been three times vaccinated without effect, and one | 
had never been vaccinated. The children were to be 
visited in the succeeding days, and notes made on a 
uniform plan by physicians told off for that duty in the 
several districts of the city ; the physicians re-assembled 
at Dr. Colon's on 30 Thermidor, when the following 
results were disclosed : ^ — 



Forty-three had either ik 
then no traces of such ac 
crusts more or less ready ti 



r had 



the inoculated spats, or had 1 
s left except dry 



' F. Colon, M.D., Observations criiiqiies sur le Ra 
Comiti central de Vaccine. Paris, An xi. (1803). 
' Precis des Conire-Epreuves Varioliques. Paris, An b 



DR. colon's evidence. 257 

Two had still redness at the inoculated spots ; 

Two had not only the crust of the primary variolous pustule re- 
maining, but also one or two pustules on the skin around ; 

One (thrice vaccinated, but each time without effect) had a few 
pustules on the variolated arm as well as on the body generally ; 

One (never vaccinated) had an ordinary smallpox eruption of 
the discrete type. 

This is all to the glory of cowpox in a fine crescendo. 
But if (changing the figure) we shuffle the forty-nine 
cards for ourselves, we shall find that a certain propor- 
tion had effects of variolation, and a certain proportion 
had none ; if we had the dates of vaccination, we should 
perhaps be able to explain why some of the variolations 
aborted. The forty-three who are meant to weigh so 
heavily in the scale are conveniently lumped together 
as if they all had the same import ; but, as an unknown 
proDortion of them had, even at the date of inspection, 
evidence of recent variolous action, and another unknown 
proportion at the same date had actiially the smallpox 
crust still adhering, the import was clearly various, and 
one part of it counterbalanced the other. It is idle to say 
that the local pustule meant nothing without the erup- 
tive fever; the state of the variolated children is not 
certified until a period when tlieir pustules were scabbed, 
and who knows whether there had been the constitu- 
tional disturbance or notP To have admitted the fever 
premonitory of the general eruption, even if no such 
eruption had followed, would have been fatal to the 
point at issue in the variolous test; for according to the 
French variolators of the time, as their practice is ex- 
pounded in the treatise of Salmade (1798), the fever 
alone was sufficient indication that the inoculated 
variolous virus had " held," If the same degree of fever 



3SS RECEPTION OF COWPOX IN FRANCE. 

(of course with the local pustule) had followed the 
variolous virus when used as a test, it would have been 
a clear inference that, other things being equal, the ante- 
cedent cowpoxing had not prevented the variolous virus 
from " holding " to the same extent. 

The Coinit^ Central itself, for all its horror of the 
charlatanism of Dr. Colon, graduallj' drifted into a way 
of withholding relevant particulars, of lumping together 
the several pieces of evidence, and of declining to can- 
vass the data up and down so as to get at the truth of 
them — ^just as Colon himself might have done. They 
report their first variolous tests on 28 Vendemiaire, an 
ix. : — 

They were done in three groups : four children on 3 Friictidor, 
an viii., three months after the vaccinations; eleven on a later date, 
two months after vaccination ; and four on another day, also 
"about" two months after vaccination. The last four all had the 
correct variolous pustule, matter from which produced the ordinary 
smallpox of inoculation ; the eleven had none of them anything to 
show for their variolation ; and of the first group of four, only one, 
the child Blondeau (whose vaccine vesicles had been so fine that 
they were selected for making a picture of), had the variolous 
pustule and the eruptive fever.' 

That is the rather meagre or summary account as l 
given by the Comit^ Central itself. The cases were 1 
known, however, to Dr. Vaume, who gives a version of 
them somewhat less favourable to the test, which it 
would be tedious to reproduce.* 

In the great variolous test* of the Comit^ Central upon 

' Jonrn. dt MM., i. 254. 

* See Les Dangers de la Vaccine. 

*-Joum. de MM., iii. 303, 



THE DECISIVE TEST IN PARIS. 259 

one hundred and two vaccinated children, whicii was 
certified by so many of the day's distinguished names 
and was perhaps the greatest testimonial that the cow- 
poxing enterprise called forth, the most essential fact in 
each case, namely the date of vaccination, is systemati- 
cally omitted. The test took place at four sittings of 
the Comit^ Central and their numerous distinguished 
assessors at the Ecole de Medecine, on. 23 and 30 Ven- 
demiaire, an ix., and on 7 and 19 Brumaire, an x., an 
additional sitting having been held on 30 Brumaire to 
observe the result in the children variolated on the 
19th. 

The first portion of the test (23 Vendemiaire) was on 37 children, 
with matter fresb from a. smallpox patient insened at not less than 
three punctures in each child ; they were all brought up on that 
day week, when the punctures were found in twenty-four to be 
effaced (iteintes), whereas in the remaining thirteen they had 
developed into pustules which had all dried up by 6 Brumaire, 
without fever, as they were told, and without general eruption fol- 
lowing. The sitting on 30 Vendemiaire was utilized for inoculating 
twenty more, of whom nineteen bore no traces of the variolation a 
week after, the other one having the local pustule. Of twenty-five 
variolated on 7 Brumaire, only two had some traces of action at 
the spot. Of twenty on 19 Brumaire, again only two had anything 
to show twelve days after. 

This great public test had an immensely reassuring 
effect. The experimental test was thought to be the 
right thing, and perfectly valid ; and what could be 
more satisfactory than the answer that it gave ? It was 
conveniently forgotten that Salmade, the inoculator for 
the Comite, when he was still practising inoculation for 
its own sake, had desired nothing more than the local 
pustule, and a degree of fever which would require 



26a 



RECEPTION Of CO'lA'POX IN FRANCE. 



some watchfulness to detect in one case, and no great 
inattention to miss in another. The same quondam 
variolator's other principle, that the action of variolous 
matter might be easily interfered with or postponed (or 
rendered abortive) by the pre-existence of another mor- 
bid process in the body, was also left out of sight, to- 
gether with the dates of vaccination, by which alone 
we could have told whether such morbid process had 
been operative. A third point not dwelt upon by the 
Comite, and probably unknown to their distinguished 
assessors, was that some of those one hundred and two 
children were stock experimentees, having been tried 
with variolous matter in vain on former occasions. 
Insusceptible subjects were never wanting in the history 
of variolation ; they were apt to be numerous among 
the scrofulous inmates of orphanages, who were often i 
used for the test. It was easy for a good many insus- 
ceptible children to accumulate for the purpose of the J 
variolous test and its repetition, by the almost unper- I 
ceived operation of a principle of selection. 

The gross experiences of everyday life were held of | 
little account beside these niceties of experimentation. 
There had been smallpox here and there in Paris among J 
the vaccinated ; there had been a more general outbreak 1 
of it among the "spuriously" vaccinated in a village near I 
Paris;' there had been a similar fiasco in a commune 
near Brussels * (where the matter used was, oddly | 
enough, also spurious, but whether spurious in the 



' Joum. de Mdd., ii. 307. 

' Rapport siir la Vaccine par les Cotmnissaires de I 
Med. de BruxeUes. 15 Thermidor, An ix., p. "ji 



KOTORIOUS FAILURE AT TOUX. 26I 

same way we know not) ; there had been deaths from 
smallpox among a number of Odier's very first vac- 
cinated cases at Thonon, near Geneva, in the then 
department of Lac Leman ; there had been distressing 
cases of the same in the practice of Dufresre at Toux, 
near Bonneville, in the department of Mont Blanc ; and 
there is mention^ also of deaths under the same circum- 
stances in the department of Mont Blanc, on the 
authority of Dr. Villars, the celebrated Alpine naturalist 
and geologist of Grenoble, which may or may not have 
been Dufresne's Toux cases over again. These all, and 
many more unrecorded, yielded to the plea of "spuria 
ous," which, as I have said before, was a mere cry, and 
had about as much rational value as a street cry of 
"mad dog" would have. As a sample I shall give tho 
Toux incident. 

Dr. Dufresne,' physician of that place, being resolved 
to give the new protective inoculation a trial, received 
vaccine on a thread from Dr. Coindet, one of the Geneva 
vaccinators, with which he raised a successful vesicle, 
thereafter vaccinating from arm to arm. He vaccinated 
a number of children, including his own child and the 
child of General Herbin. Some time after, smallpox 
broke out, and most of the vaccinated children were 
attacked, Dr. Dufresne's child and General Herbin's 
both dying of it. The doctor and the general concluded, 
not unnaturally, that vaccination did not protect from 

' J. M. Reynald, M,D., Rijlexions mr la Vaccine. Albi. An 

» His narrative is printed in the Rapport sur la Vaccini, by the 
Commission of the Soc. de M&L de Lyon, Lyon, An. ix. 



IJ 



262 



RECEPTION or COWPOX IN FRAA'CE. 



I 



smallpox ; and that was, perhaps, the less reasoned im- 
pression left upon the parents in humbler life whose 
vaccinated infants had succumbed in the same epidemic. 
Dr. Dufresne wrote a letter detailing the facts to the 
Vaccination Committee then engaged upon inquiries at i 
Lyons. These eminent Lyons doctors thought that 
their Toux colleague had been hasty in his conclusions : 
" la douleur paternelle excuse la precipitation d'un 
pareil jugement." Accordingly they wrote to Dufresne 
for further particulars. Had not the vaccine become 
spurious in some way? perhaps, in his arm-to-arm 
practice, he had passed it through the body of a child 
which had had smallpox before? was he sure that the 
vaccine vesicles were correct to look at? To these 
questions Dr. Dufresne returned no answer, feeling, 
perhaps, too sore all over to enter upon metaphysical 
subtilties of that kind. Odier, of Geneva, the great 
promoter of vaccination in Switzerland, was accord- 
ingly appealed to; he confirmed the fact that "most 
of Dufresne's vaccinated subjects had taken smallpox 
subsequently, and that several had died"; but, from 
what the faiher of one of the children had told him, he 
thought it " far from certain that they did not all have 
spurious vaccine ; "—with which very thin whitewashing 
the incident was covered up for the time, and, of course, 
very soon forgotten. 

The plea of "douleur paternelle," to excuse the very 
exceptional conclusion come to by Dr. Dufresne, was 
re-echoed in Berlin about the same time, by way of 
accounting for the hostile attitude of Dr. Wolfram, a 
regimental physician in the Prussian army, who had at 
an early date taken a profound interest in the Jennerian 



THE LYONS COMMISSION. 263 

project. Being anxious to get the very best matter for 
the vaccination of his own httle girl, he had written to 
Jenner, but received no reply. He then got matter 
from Stromeycr, of Hanover, which did not "take"; 
and in the end he was supplied by Heine, of Berlin, 
with vaccine which produced vesicles on his child's arm 
as described by him in full detail. The child caught 
smallpox of a bad type in the epidemic some time after, 
and died on the 13th of March, 1801.^ 

The Lyons Commission on Vaccine,' which was con- 
fronted with the facts of the Toux disaster, held its head 
as high, scientifically speaking, as any of the persons, or 
associations of persons, who undertook to give an opinion 
on the merits of Jenner's project. They intended to go 
below the surface, so as to get at the real truth ; they 
would avoid enthusiasm on the one hand, and carping 
detraction on the other. If there had been discoveries 
in the past kept back unjustly, many more had been 
" rushed " with foolish enthusiasm ; and they, the Lyons 
physicians, were going to commit neither the one mis- 
take nor the other. Let us see, then, how they justified 
these brave words. 

Their report contains a table of the one hundred and 
fifty-seven persons vaccinated by, or under the observa- 
tion of, the Commission, with certain particulars for each 
case. Forty of these were children in the Hospice des 
Vieillards et Orphehns de Lyon, where cases of small- 
pox were occurring about the same time. Only two (or 
three) of the successfully vaccinated, who were thus ex- 



' Meilicinisch-Chirurgiiche Zeilungt iv. Ill, 1801 
* Rapporl sur la Vaccine. Lyon, An ix. (1801). 



I 



264 RECEPTION OF COWPOX IN FRANCE. 

posed, caught smallpox ; and in them the eruption 
appeared on the tenth day from vaccination, so that it 
was within the recognised limits of concurrent infection 
Nearly all the cases of vaccination in the hospice, or out 
of it, are briefly given as "regular"; but we learn from 
the text that there were a number of cases of bad arms 
(ulcers discharging ichor, and with livid edges, most of 
which healed without treatment, while the more invete- 
rate yielded to the action of " I'eau phagedenique "), and 
some cases of spurious vaccination, the latter, oddly 
enough, corresponding to cases (in the city) in which 
smallpox was " understood," or was " suspected " to have 
occurred subsequently. There were, indeed, two species 
of vaccine, a true and a false, " which latter is not pro- 
tective against smallpox," 

At Lyons, the great variolous test was applied just 
twelve times, among the forty children vaccinated at the 
Hospice ; the Commission say that they might have 
done it on all the forty, but they were keeping some of 
them to try it later. 

They were well satisfied with the result of the test in those 
twelve ; "none has developed the smallpo;* ; in some the punc- 
tures have had a red blush round them, or have become an elevated 
point, which has promptly subsided." In the table we find the 
particulars of the twelve tests which were thus reassuringly sum- 
marised. Each of the twelve is entered in idetilical terms in one 
of the columns as "variola sans succfis." In none is the date 
given of the vaccination, or the interval between that and the 
variolation ; but it is evident from the contest that the latter fol- 
lowed quickly on the former. From other columns of the table we 
gather that three of the twelve selected for testing had required 
to be inoculated a second or a third time with cowpox before they 
"took," whereas they would seem to have had only one (perhaps 
perfunctory) chance with smallpox. Three more of them were 



^^M THE TESTIMONY OF AMIENS. 265 

arttRciaUy variolated afUr their attack of nataral smallpox in the 
hospice (an absurdity for which Woodville was responsible in the 
first instance) ; and one had ulcers of the vaccinated spots until the 
thirty-second day. For the remaining five no particulars are given. 
If tliese were the data and conclusions respectively in 
the great medical school of Lyons, it is not to be ex- 
pected, nor is it the case, that the records of the trial of 
cowpox at Rheims, Poitiers, Lille, Rouen, and other 
towns in France, will show to better advantage under 
critical examination.^ I shall give details for only one 
other centre in France, the city of Amiens, where there 
was a pretentious Jury of Health, dating from the 
revolutionary period, and eager to try all innovations 
offered for the benefit of mankind. The Marquis Corn- 
wallis being then {1802) at Amiens, as British pleni- 
potentiary to the Congress, the Jury of Health took 
occasion to present him with an address.^ 

The address assures Lord Cornwallis that the jury 
are constantly occupied with whatever relates to the 
preservation of man. Vaccination has justly called 
forth their particular attention. In the course of a year 
a great variety of experiments have been made here 
upon six hundred persons. The vaccine is now proved 
to be a protective against smallpox ; this can no longer 
be doubted, England has the honour of this discovery. 
The friends of science never interrupt their fraternal 
intercourse, although their governments may be wield- 
ly ' On the report of the Comite Central, that vaccination had all 
1 the mefils of variolation and none of its demerits, tlie Minister of 
\ the Interior issued, on 6 Flordal, An xi. (r8o3), a circular to the 
Preftcis of Departments, advising the general adoption of the new 
protective.— /o«r«. i/e MM, vi. 481. 
' Med. andPhys. Joum., vii. 201. 



266 



RECEPTION OF COWPOX IN FRANCE. 



ing the thunder of war. We have repeated the experi. 
ments of the immortal Jenner, and we have found them 
correct. None of our experiments were more decisive 
than those which we shall relate to your excellency. 
We relate them not so much for our gratification, as for 
the benefit of medicine and of humanity ; and in laying 
them before you, we wish that the glory which has been 
acquired may be transmitted to the discoverer. On the 
25th of la.st Germinal, three infants (ye gods ! three 
infants) at the Hospital St. Charles, named Duneuf 
Germain, Fracaster, and Pisson, who had before been 
vaccinated with success, were now inoculated with small- 
pox matter. This produced no effect. The triumph 
of vaccine was proclaimed. To meet objections which 
had been raised, the Jury of Health at Amiens inocu- 
lated the three children again after six months, on 
25th Vendemiaire, and again they failed to take small- 
pox. After this, who shall dare to assert that the 
vaccine is not a preservative against the smallpox 
Accept, my lord, our homage, and this account of the 
last experiments we have made, as an offering which we 
have the honour to present to you. We have already 
declared that the French physicians have never ceased 
to consider themselves as brothers to your physicians ; 
and when you have finished your important labours at 
Amiens, the two nations will love each other reciprocally, 
and France and England, glorying in their valour, united 
by mutual esteem, shall command repose to the rest of 
the world. 

Alas ! the enthusiasm of these rhetorical doctors for 
the extermination of smallpox was just as vain as their 
enthusiasm for the cessation of war. 



I 



CHAPTER XI. 

THE JENNER OF ITALY. 

THE story of the introduction of cowpox inoculation 
into Italy is so full of significance that it deserves 
to be told, even at the risk of extending this history to an 
excessive length. Dr. Luigi Sacco, " the most extensive 
vaccinator in the world," and emiilo del Britanno Jennet 
(as he is described on his monunient in the Ospedale 
Maggiore of Milan), was one of those enterprising young 
practitioners, rather common in all countries, who 
promptly seized upon the novelty as a handy means to 
reach fame and fortune. He was one-and-thirty when 
he suddenly emerged into notoriety in Milan as a vac- 
cinator. His career from the year of his graduation 
(variously given as 1792 and 1795) until his appearance 
in Milan in 1801 with a stock of vaccine lymph in his 
possession is wrapt in obscurity. He had already lived 
in Milan for a time, and had been awarded a medal by 
the Patriotic Society of that city for a paper on a " New 
Way of Preserving Insects," which is rather paradoxically 
introduced with the motto from Cicero that "honest occu- 
pations are to be preferred to useless and base leisure."^ 

^ The paper is printed in Amoretti's Opuscoli Sceleti sulh 
Scieme^ etc.^ xix., 1796. 

367 



268 THE JENNER OF ITALY. 

His biographer^ says that he ** travelled about in Italy 
in order to learn more, and was always eager to visit 
America." On one occasion he was actually on the 
point of embarking for the New World, but was kept 
back " by the prayers, not to say the command, of a 
reigning princess." This mysterious intervention was a 
special providence, for the ship was wrecked. Making 
some allowance for a mythical halo surrounding his early 
years, we may take it, at least, that Dr. Sacco had been 
a rolling stone. Another biographer^ locates him for a 
time at Chambery, as medical officer to the H6pital 
Civil. The medical journal which introduced his first 
vaccination book to English readers in 1802, spoke of 
him as " a medical man of great eminence in Italy,*'* 
which he certainly was not. It was vaccination that 
made his fortune, and it was he that made the fortune of 
vaccination on the other side of the Alps. 

In the autumn of 1800, "a fortunate combination of 
circumstances," as he says,* obliged him to take up his 
residence at Varese, which was his native town (and has 
now a Via Sacco to commemorate him). Jenner s cow- 
pox notions had been made known to Italian readers a 
few months before in the translation of the Inquiry 
by Careno of Vienna ; a few vaccinations had also been 
tried at Genoa in April, 1800, by Dr. Scassi, with lymph 



^ Vita ed Opere del grande Vaccinatore Italiano^ Dottore Luigi 
Sacco, By Cav. Dr. Giuseppe Ferrario, Milano, 1858. 

' Quoted in Callisen's Medicinisches Schriftsteller- Lexicon, 1846. 

3 Medical and Physical Journal. Feb., 1802. 

^ Osservazioni pratiche suW uso del Vajulo Vaccino, come Pre- 
servativo del Vajulo Humano, Di Luigi Sacco, M.D. New edition. 
Milano, Anno x. (1801). 



ORIGINAL COWPOX AT VARESE. 269 

sent from the Geneva stock. At Varese, in September 
of that year, Sacco took occasion to ask questions about 
cowpox of certain cattle-drovers and dealers whom he 
encountered on their way home from the fair at Lugano. 
A dealer of Cremona told him that he had at that 
moment resting in a neighbouring meadow a drove of 
forty cows which had come down from the Swiss moun- 
tain pastures, and had all been affected successively with 
" pustules on the ends of their teats." He took the doc- 
tor to see them, and pointed out several which had still 
the crusts upon their teats. Sacco picked off some of 
the crusts and kept them. 

When he remarked that he would prefer the proper 
fluid matter of the cow's vajulo or smallpox, the cattle- 
dealer offered to take him to another drove belonging to 
a friend of his, which was also halting at Varese. Two 
cows in that herd were pointed out, with red spots on the 
teats and udder, which the animals would hardly allow 
to be touched. Next morning Sacco found, in one of 
the two cows, four elevated and tumid pustules, three 
being on the teats and one on the body of the udder; 
in the other cow he found six pustules of larger size and 
surrounded by a zone of redness, only two of which 
were on the teata. The pustules did not appear to be 
ripe for yielding matter ; and as the drove was going to 
make another stage that day on the road to Milan, the 
doctor went the distance with them. On the following 
morning he found the pustules of a pale red colour, 
translucent, and with a commencing brown spot in the 
centre ; with the help of the drover, he had no difficulty 
he says, in taking off matter by soaking a thread in it 
repeatedly. 



270 THE JENNER OF ITALY. 

There the narrative ends. But it was illustratec 
the second edition of Sacco's ensuing work, if not in 
the first, by a large plate of a cow's udder bearing ten 
natural vaccine vesicles, of round shape, on the teats, 
and two artificially inoculated vesicles, of oval shape, on 
the body of the udder. This plate was the first ever 
given of cowpox in the cow, Jenner having; given none; 
it was reproduced in England' in 1S02, and in France 
and Germany subsequently. It is not like any original 
pox of the cow's teats that has ever been described or 
figured by any one else. The picture appears to have 
been constructed by drawing a cow's udder, and then 
filling in a number of vaccine vesicles of the conventional 
type here and thereupon the teats. This plate did duty 
for forty years ; and it must have given great satisfaction 
to all those, whether in England or abroad, who had 
heard more than enough of a filthy, ulcerous, corroding 
disease of the teats requiring to be checked with caustic, 
and were puzzled to know how such an affection as that 
could be smallpox of the cow. The charming illusion* 
of Sacco's neat and clean-looking vesicles on the cow 
was not disturbed until Ceely's realistic narrative and 
drawings forty years after ; but by that time the fixed 
idea of "smallpox of the cow" had gained so completely 
the upper hand in the vaccination doctrine that even 
Ceely himself disregarded his own revolting experience 
in the Aylesbury cowhouses, and went off into the 

' Medical atid Physical Journal, vol. vii., March, 1802, 
' In a note to p. 42 of his Osserunztoni, he admits that he had 
never found in cows the phaoedenic ulcerations which Jenner had 
spoken of. He had not found them because he had not looked for 
them, being a mere tyro in the matter when he wrote as above. 



THE VARESE STOCK SPONTANEOUS. 271 

pleasant by-paths of an experiment to inoculate human 
smallpox upon a semi-exposed mucous membrane of the 
heifer, thereby persuading himself that that also was cow- 
pox. He was not even undeceived when his assistant, 
having accidentally pricked his hand with a lancet 
covered with pus warm from the heifer's pustule, de- 
veloped in due course an ordinary smallpox pustule at 
the spot, and an ordinary smallpox eruption on his face 
and elsewhere a few days after. 

Sacco's account of how he found original cowpox at 
Varese is so circumstantially conceived that its omissions 
call for remark. Was it with the crusts from the first 
tirove, or with the thread soaked in matter from the two 
cows in the second, that he made his [vaccinations.-' 
The existence of cowpox among the forty cows wliich 
had come down into Lombardy from the high Alpine 
pastures at the end of summer is intelligible enough. 
It was just when a cow was taken to market, being driven 
or kept standing with her udder full, that the pimples, 
cracks, or other common ailments would arise, out of 
whicii cowpox ulcers might be induced through the rough 
manipulation of the teats by the milkers, and might be 
conveyed by them to other cows. The market-cow sort 
was admitted by Jenner to be a common type of the 
spontaneous cowpox ; only he laid it down quite clearly 
in the Inquiry, but also quite arbitrarily to serve a 
disingenuous purpose, that it was at the same time 
spurious. The crusts which Sacco took from the teats 
of these cows at Varese would doubtless have furnished 
the cowpox virus for inoculation ; indeed, the crusts of 
the sore teats were the only form in which Ceely could 
ever get original vaccine virus, notwithstanding all his 



2/3 



THE JENNER OF ITALY. 



careful search for fluid matter from unbroken vesicles ia ' 
several outbreaks during a number of years at the 
dairy-farms near Aylesbury.' 

Sacco does not say that the drove of forty cows were 
in milk ; but it is not easy to understand tlieir all having 
had cowpox unless they were, or had lately been so. 
He is throughout under the influence of the idea that 
cowpox is smallpox of the cow, and he notes no fact 
that is at variance with that idea. He argues against 
the possibility of cowpox arising from those simple or 
physiological causes which were commonly assigned by 
the dairy folk and the veterinarians. Cows with dis- 
tended udders are to be found, he says, everywhere ; and 
yet cowpox is rare. Again, he argues, women may have 
distended breasts from refusing to suckle their infants, 
and although eruptions sometimes befall them in co: 
quence, producing thick crusts and serious inconven- 
iences, yet there has never been a single instance of 
contagion from the disease of their nipples so produced. 
Nothing can show better than that illustration how 
entirely Sacco missed the point which other observers 
have emphasized in cowpox: namely, that it is the 
rough handling of the chapped, or pimply, or otherwise 
sore teats by the milkers twice or thrice a day, and the 
necessary aggravation of any soreness which the ever- 
renewed irritation entails, that causes the infective and 
communicable properties of cowpox to arise. No one 
who knew the common experience of cowpox at dairy | 



■ The same difficulty was noted as early as March, 1802, in the 
outbreak of cowpox at Thorpland, near Downliain Market, Norfolk. 



See Mtd. andPkys.Jou 



SACCO AS A PATHOLOGIST. 

farms ever alleged that it was contagious, as smallpox is; 
yet Sacco, being dominated by the idea of vajulo vaccina, 
and having had no previous practice in dealing with the 
" pathology " of infective diseases, repeatedly speaks of it 
as contagious {pp. 38 and 56) ; and only at the end of 
his essay, when he is treating of the inoculated vaccine, 
does he draw the stock distinction between it and inocu- 
lated smallpox, with the intention of getting the usual vote 
of confidence in the former because it is non-contagious. 

His pathology of cowpox and smallpox is almost 
advanced enough for an " expert " of the most recent 
type. Both diseases, he says, are exanthems ; and there 
is a theory that exanthems are caused by worms insinu- 
ating themselves under the skin, and there developing. 
Itch and other contagious diseases are thought to be 
owing to worms; and why not smallpox.' But he had 
as yet got no microscope powerful enough to give posi- 
tive results in that highly promising field of inquiry. 
With his theory of cowpox being due to worms, Sacco 
had little need to consider the common sense -of its 
origin ; that was an aspect of the matter which any or- 
dinarily reflective and humane person could deal with, 
whereas it is given to but few to discover the more 
minute forms of worms with a high-powered microscope. 

Before we proceed to his practical work as a vac- 
cinator, it will be convenient to deal at this point with 
Sacco's other services to the theory of cowpox as a 
disease and as a protective. The first thing that we 
have to notice is his astonishing fertility in devising 
experiments. Knowing nothing and caring nothing 
about the vulgar circumstances amidst which cowpox 
arises in various countries, or about the true significance 



I 



274 



THE JENNER OF ITALY. 



of its characters as milkers experienced them, he in-^M 
stituted a series of experiments with vaccine lympll(i 
which were of so sporting a kind that he could not havafl 
failed, had he lived now, to gain the approval of thei 
medico-scientific leaders, even ;f his adherence to th^ 
worm -pathology had not assured him of that before, HeJ 
vaccinated seven dogs, and, on applying the varioioiu 
test to six of them, found that they were protected ji 
he would have tested the seventh also, only it had t** 
go with its master on a journey. One of the cowpoxed I 
dogs became rabid, and bit a number of persons, none I 
of whom took hydrophobia. He communicated cowpox J 
also to the ox, the calf, the sheep, and the pig. lixceptj 
in the case of the sheep, of which more in the sequel, theS^ 
experiments appear to be meaningless. But thes 
domesticated mammals were a mere fraction of all thtf 1 
animals he experimented upon. He inoculated cowpox^ I 
also on wolves, bears, apes, cats, mice, rabbits, hares, and* f 
squirrels; also upon hens among the avian class, upon j 
snakes, lizards, and frogs in the reptilian and batrachiaH' I 
classes, and upon certain unnamed fishes. Experiments" I 
upon the various classes of the invertebrata are un- 
fortunately lacking. The results were mostly too 1 
indeterminate for him to record in detail ; but he"| 
mentions that the cowpoxing of the hen succeeded.^ 

Whatever may have been the scientific truths which 4 
the experiments on these several species of animals were d 
calculated to draw forth, the experimental cowpoxing"! 
of the sheep had a real practical or economic interest.-J 
The sheep in Italy, especially the flocks of merinoSjS 



k 



* Trattaio tU Vacciaazione. Milano, 1S09, p, 17S 



COWPOX NO PROTECTIVE FROM SHEEl'-l'DX. 275 

•were from time to time decimated ty a smallpox {vario/a 
ovina) which was the same in all respects as the small- 
pox of man. The district of Padua had suffered much 
from that scourge among the sheep in 1797, and there 
were isolated occurrences of it in subsequent years. In 
the course of his vaccination journeys, Sacco found it in 
1804 among sheep near Capua, and again in October, 
1S06, near Montemiscoso. On the latter occasion he 
cowpoxed several sheep ; they developed vaccine 
vesicles, and resisted the variolous test which was tried 
upon them soon after, nor did they catch the conta- 
gion from the tainted part of the flock. After that 
triumphant test, Sacco persuaded several extensive 
flockmasters to have their sheep {especially merinos) 
cowpoxed, the consequence being that the smallpox 
was driven from among them. What really came to- 
pass was one of those periodic lulls which occur in all 
epidemic or epizootic contagious diseases. Whenever 
the time came, smallpox of the sheep raged as before ; 
cowpox had absolutely no relation to it, or relevancy in 
the matter, being another sort of pox altogether. 

The protective power of cowpox against the smallpox 
of sheep is a delusion which has been confessed with 
brutal frankness by those whose pockets are concerned. 
It took some time to arrive at the truth of the case; 
but as soon as the truth was apprehended, the sensible, 
practical step of ceasing to vaccinate for sheep-pox was 
taken, regardless of what might happen to the pro- 
fessional credit of those who had warranted it. The 
following is the authoritative summary by Dr. William 
Budd, in 1863':— 

' Variola Ovina, Address in Medicine at Bristol Meeting of 



\ 



276 



THE JENNER OF ITALV. 



"Against ovine smallpox-, vaccination offers 
specific protection at all. It has been proved by 
pcriments on an enormous scale, performed under 
every condition to ensure accuracy, that vaccinated 
sheep, when afterwards exposed to the infection of 
claveli!e, take the disease in large proportion in the 
natural way; and that when inoculated with it, they 
not only incur the usual consequences, but suffer quite 
as severely as unvaccinated sheep." 

This is all the more remarkable, that sheep, when vac- 
cinated, develop the same vaccine vesicle as man does, 
and that lymph taken from the vaccine vesicle of a sheep 
produces the correct vesicle in man. Dr. Budd adds that 
this correct vesicle in man, raised by cowpox lymph 
from the sheep, protects the human being from smallpox, 
although its original, and exact counterpart, in the sheep, 
gave no protection from ovine smallpox. Men are not 
like sheep in that respect. Sir James Paget has said 
"Jenner had to fight his fight for the benefit of men's 
lives against a vehement opposition ; to that for the 
benefit of cattle, which are human property, there is no 
such opposition. It is truly a fact that we may we! 
remember; though it is not a novelty to many in our 
profession, who have frequent opportunities for seeing 
how much more valuable a man feels his own property 
to be than his neighbour's health, , , . Property 
and healthy life may soon be regarded as more nearly 
equivalent than they have been hitherto." 

British Medical Association, 1863.— .5r//. Med. /ourn.,kaz. 8th, 
p. 147. 

' Speech in proposing a vote of thanks to M. Pasteur at the 
International Medical Congress, London, 18B1. Transactions, I 90 



CHILDREN INOCULATED WITH SHEEP-POX. 277 

The marvellous power of names, as contrasted with 
realities, over men's thoughts and actions is shown by the 
Italian dealings with sheep-pox in another way. It oc- 
curred to some, in the first flush of Jenner's inoculation, 
that as cowpox prevented smallpox, sheep-pox might 
do so also. Vai'iola hnmana, variola vaccina, variola 
ovina — these were three equivalent forms ; and why 
should not the sheep-pox serve as well as the cowpox 
to ward off the smallpox ? Accordingly, when Sacco, in 
1804, obtained variolous lymph from infected sheep at 
Capua, he gave it to Dr. Legni in the remote Sicilian 
province of Cattolica to try as a substitute for vaccine 
in the prevention of smallpox. It was not until four 
years after {29th June, iSoS) that Dr. Legni sent to 
Sacco an account of his experiment : he had inoculated 
the variola ovina upon several children and found that 
it produced effects very like those of vaccine; he used 
it continuously in his practice for two or three years, and 
had inoculated three hundred with it ; about the time of 
his using it, an epidemic of smallpox broke out — he had 
been diffusing ovine smallpox all the time — but all those 
inoculated with the variolous virus of the sheep passed 
through it unscathed.^ 

The last of Sacco's various services to the theory of 
■cowpoxing is his enthusiastic adoption, in 1802 or 1803, 
of Jenner's doctrine of the horse-grease origin of genuine 
cowpox. The cowpox at Varese had clearly nothing to 
do with horse-grease, and Sacco, in his first book, 
■criticised Jenner's facts and reasoning thereon with some 
severity ; he remarked that Jenner had nothing better 



I 



278 



THE JENNER OF ITALY, 



than conjecture to base his theory on. At the same 
time he had caught up the clap-trap talk about " genuine 
and "spurious," although he does not seem to have 
apprehended Jenner's motive in making the spontane 
cowpox a spurious sort. Being a keen experimenter, he 
had not been long settled at Milan when he went back 
to the horse-grease question, and in course of time 
satisfied himself that Jenner's doctrine was correct, 
Jenner himself having meanwhile quietly dropped 
except in Iiis private correspondence.' Sacco obtained 
some matter from the ulcerous sores on a horse's hocks 
(he gives a startling picture of huge, excavated horse- 
sores in his Trattato of 1809), and therewith inoculated 
several children at the Foundling Hospital of Mill 
He found that the effects were very like those of cowpox 
virus (as we know, in fact, that they always are) ; and, 
on trying the children with the variolous test, he found 
that they were protected just as if they had been cow- 
poxed. 

Accordingly, in a letter to Jenner, dated the 2Sth 
March, JS03, he admitted that it was quite certain the 
grease causes the vaccine, and he suggested that one 
might by-and-by change the latter name into equine'; 



' In a letter to De Carro (a8ih March, 1803) Jenner says :- 
" I am confident that had not the opponents, in this country, td 
my ideas of the origin of the disease been so absurdly clamorous, 
particularly the par nobile fratrum [Pearson and Woodville], the 
Asiatics " would, now be enjoying, etc. De Carro replied, on 2znd 
April, " P 's conduct borders on insanity." 

■ "J'ai d^ji inocu!^ plusieurs des ces individus avec la petite 
i-^role, mais sans aucun effet. C'est done bien si'ir et consentt 
que le grease est cause de la vaccine, et on pouvait bientGt changer 



nOR.SE-CREASE AS EFFECTIVE AS COWPOX. 279 

He sent his horse-grease matter to De Carro, in Vienna, 
who used it freely and gave of it to others. In a 
letter of iSo4,^ De Carro signs himself "vaccinator et 
equinator" ; and many years after he wrote as follows ; 
"The matter in use at Vienna from 1799 to 1S25 was 
partly British vaccine, and partly originated from the 
grease of a horse at Milan, without the intervention of 
the cow. The effect was so similar in every respect 
that they were soon mixed ; that is to say, after several 
generations, and, in the hands of innumerable prac- 
titioners, it was impossible to distinguish what was 
vaccine and what was equine." * 

This, then, was the adventurous person who intro- 
duced vaccination into the Cisalpine Republic, and on 
whose sole credit, apart from foreign testimony, it was 
adopted by the State, Having vaccinated twenty-six 
persons {including himselfj at Varese, In October and 
November, iSoo, with matter from the Swiss cows, and 
tried the variolous test at once upon six of them, he 
removed to Milan, and performed his first vaccination 
there on the 8th of December. He lost no time in pub- 
lishing his book,^ in which a great point was made of his 
stock of virus having come from an indigenous Lombard 
source, and of the mildness of the same as compared 
with Jenner's cowpox. He was hailed as the Jenner of 

cette denomination en equine, ou en ce 1 
Baron, i. 251. 

' Letter to Ring, in Med. and Phys. Joitrn., N 

' Cited by Copland in the iiiticle " Vaccination, 
of Practical Medicine. 

* Osssrvazioni praticltc sulla Vajiilo Vaccino. 




28o 



THE JENNER OF ITALY. 



Lombardy, and in a few months was appointed Director 
of Vaccination for the whole Cisalpine Republic. Writ- 
ing to Jenner on the i6th of October, 1801, he says 
that he had performed more than eight thousand vac- 
cinations with his own hand. 

At that stage of his work hesent someof his Lombard 
cowpox matter to Woodville, in London, who was 
fortunate as to produce the genuine cowpox" with it ; 
some of it, used by Ring, "has produced the genuine 
pustule and is now being used widely." It was spon- 
taneous cowpox, however, if any cowpox ever was so; 
and Jenner's original teaching, as well as his later teach- 
ing, when it suited him {c^^., Letter to Dunning, 2nd 
April, 1S04), was that the "spontaneous cowpox was 
no preventive." For most persons it did not matter at 
all how the genuine and the spurious covvpoxes were 
respectively defined ; a spurious variety was wanted 
along with a genuine merely for an apologetic purpose, 
and the more elastic the terms were, the easier tire- 
apology for failure or disaster. 

Sacco's enormous number of vaccinations in the first 
few months amounted to a real propaganda. The intro- 
duction of cowpoxing into Italy was a sudden dash on 
the part of a hitherto unknown person with talents 
suited to the business, who saw his opportunity and was 
prompt to seize it. Two or three months before he 
found the cowpox at Varese, a number of the Milanese 
doctors had indeed published on the 22nd of June, iSoo, 
a testimonial ^ in which they ai?irmcd, without any ex- 
perience of their own, the four stock propositions, that 



• Printed in Sacco's Ossemazioni praticke, 1801. 



SACCO'S PROFESSIONAL STANDING. 281 

covvpox prevented smallpox, that it was not contagious, 
that it produced no eruptions, and that it was attended 
with no risk. This was merely copied from the English, 
and it is not easy to see why the Milan doctors should 
have put their names to it. It may be inferred from a 
remark by Buniva, of Turin, who writes on vaccination 
in Italy in 1801 without mentioning Sacco's name,i that 
there were some, at least, who hesitated about Jenner's 
novelty ; and there were probably more who hesitated 
about Sacco. If they had read the English history of 
vaccination with a moderate degree of attention, they 
would have detected the following passage in their own 
Sacco's Osservazioni of 1 80 1 to be the romancings of an 
extremely untrustworthy person : " But this discovery, 
so fortunate for the human race, shared the fate of other 
grand and useful discoveries by encountering much 
opposition at its first outset. The basest envy let loose 
all its virulence against the discoverer on his appearance 
in London, but its attacks only made him redouble his 
diligence to bring his discovery to perfection. For a 
moment he retired from his enemies, to confound them 
on his return witJi the victorious arms of multiplied 
observations and the most decisive experiments. At a 
distance from the clamours of a populous city, in the 
retirement of Gloucestershire, where cowpox is almost 
endemic, Jenner had an opportunity of continuing his 
■experiments in the fullest tranquility." ^ Of all the 
rhetorical nonsense written about Jenner, that is the 



' Calcndario Georgico della Soctetd agraria Subalpina. 
1802, p. 23. 
' Translated in Med. and Phys. Journ., vii. (1802), 169. 



I 



283 



THE JENNER OF ITALY. 



most nonsensical ; and the man who could write . 
purely out of his head, might well have been looked 
upon with distrust by the responsible leaders of medicine 
in Italy. 

But opportunities soon arose which excited popular 
enthusiasm for Sacco. There had been a complete 
cessation of smallpox epidemics in Italy (excepting 
Sicily) since 1796, after an unusually severe prevalence 
of them all over the country. At length a small and 
mild outbreak occurred at Giussamo e Sesto, at the 
lower end of the Lago Maggiorc ; thither Sacco repaired 
as a deliverer, "suffocated" the epidemic, and established 
the "first triumph of vaccine."^ It was after this that 
the Republic appointed him Director. Another isolated 
outbreak occurred at Bologna the same year, which he 
dealt with in like manner, and had a gold medal given 
to him by the grateful citizens, of which he reproduced 
two cuts afterwards in one of his books : it bears on one 
side his effigy, and on the other side the inscription 
^mulo Jcniieri ainici Bcniioiieiises. In the spring of 
i8o2 there was a rather more severe outbreak in the 
province of Brescia, in which many died. The Govern- 
ment, careful of the lives of the citizens, " cast a beseech- 
ing look upon him," and he hastened to the rescue. 
The plaguewas stayed {by vaccinating 13,000 in a popu- 
lation of 300,000 or 400,000), and the deliverer again 
received a gold medal, whereon Sacco is represented 
in the act of extracting lymph from a cow's teat.^ 



■ TnUlalo di Vitu 

' On tlie evening of the day when I had written the above passage 
1 took up the ZunciT/ of that date (7th July, 1S88, p. 32), atid read, 
in an editorial note on " Smallpox in Milan," as follows :— 



THE MEDICAL LEADERS SATISFIED. 2S3 

After these popular successes, the medical leaders 
could no longer afford to be sceptical or indiff'erent. 
Accordingly it was arranged that their scruples should 
be satisfied in due academical form, and " a solemn 
experimental test" was announced to be held at the 
Orfanotrofio della Stella, in Milan, on the 31st of August, 
1802. It took place in the presence of " many of the 
authorities of the Republic, the professors of the faculty, 
and other learned persons." ' Sacco opened the pro- 
ceedings with an eloquent speech. He then introduced 
a child at the eighth day of a copious natural smallpox 
eruption, and invited the assembled professors to satisfy 
themselves that it was really smallpox. Sixty-three 
children or adults, mostly inmates of the orphanage, 
who had been vaccinated at various dates since June 
of the year before, were then called in one by one, and 
inoculated with smallpox from the child in attendance. 
The assembly then adjourned until that day fortnight. 
Those who came back on the 14th of September to hear 
the result were informed by Sacco that the variolous 
inoculation had not in general produced any effect, only 
a few having had some local trouble. But two unvac- 
cinated persons, who had been taken into the experiment 

" Smallpox and typhoid are never wholly absent (torn the Milanese 
population ; the former especially having periods of recrudescence, 
sometimes so sudden and so pernicious as to amount to positive 
' explosions." One of these has declared itself within the last week, 
antf, as usual, there is a wkipptng-iip of the people to the vaccinating 
stations, in the vain hope that such spasmodic and unsystematic pre- 
cautions can slay the disease." Shade of Sacco ! 

' " Contra-prova della Vaccinazione : " the official report, printed 
in vol. xxii. (p. 121) of Amoretti's Opuscoli Sceleli sulle Sciense, 
Milano, 1803. 



I 



i 284 



THE JENNER OF ITALY, 



as shocking examples, were pronounced to have 1 
"completely infected by the variolous inoculation," one of 
them, an adult, having had four pustules on his arm, which 
were dried up at the eighth day, and the other, a child- 
of two, three pustules on the left arm, two on the hand, 
two on the shoulder, three on the right arm, and one on 
the forehead. 

Sacco's credit was now completely established in the I 
best circles. That year he was admitted to the fellow- 
ship of the Milan Academy, and appointed medico I 
primario to the Ospedalc Maggiore, as a recognition of I 
his vaccinating zeal. 

The next epidemic of smallpox was at Florence, in 
1805 ; and in November and December of that year Sacco 
held another " solemn experimental test " for the satis- 
faction of the chiefs of the Florentine Royal Medical 
and Chirurgical College. Eight children just vacci- 
nated by Sacco on the fith, i6th, and 24th October (one 
of them being the vaccinifer whom he had brought from 
Bologna), together with four old vaccinated cases of iSoi 
and 1803, were brought together on the 24th November, 
1805, and inoculated with smallpox from a confluent 
case at the ninth day, in the presence of official delegates 
and other representative medical men.' Three physicians 
who had been taking a lead in the movement were 
delegated to watch the children meanwhile ; and the 
whole were ordered to present themselves again that 
day fortnight, the 8th of December. Nineteen medical 
practitioners certified on that day that, according to \ 



A DELAYED TEST AT FLORENCE. 385 

what was reported to them and what they had seen, 
none of the twelve children variolated after cowpox had 
been attacked with smallpox, nor had any shown consti- 
tutional symptoms, and that no effects had followed, 
except some slight irritation at the place of insertion. 
Therefore they concluded that vaccination prevented 
smallpox. Another testimonial, signed on behalf of the 
Royal Medical and Chirurgical College by four of its 
members deputed, speaks of vaccinations done by Sacco 
at the Spedale degl' Innocent! on the_ 13th, 17th, and 
21st of November, and of the experimental variolous 
tests on the children, on the 34th of the same month. 
It need hardly be pointed out that the children in 
orphanages were just the subjects who would have their 
lymphatic glands stirred, by the absorption of the cow- 
pox virus, into plastic activity (which might go on to 
scrofula), and that the absorbent glands would be so far 
deprived of their function as to fail in taking up and 
transmitting another virus introduced under the skin of 
the same region a few weeks or even days after. 

This formal scientific proof at the end of an epidemic 
in Florence, in 1805, reminds one of hanging a man 
first and trying him afterwards. Sacco had been for 
more than four years Director of Vaccination to the whole 
Cisalpine Republic. He had visited all parts of Italy in 
his mission as a cowpoxer (or horse-greaser) from the 
Lago Maggiore to the farthest district of Sicily, and had 
inoculated some hundreds of thousands with his own 
hand. In a letter to Jenner, dated Trieste, the 5th 
January, 1808, he says : ' " During eight years I reckon 



286 



THE JKNNER OP ITALV. 



more than 600,000 vaccinated by my own hand." 
his quarto treatise,' publish<;d more than twelve months 
later, the number has decreased to 500,000, so that we 
■may take Sacco's figures as not intended to be accurate 
to a hundred thousand or so. In iSoG, vaccination was 
publicly enforced, by various indirect means, almost as 
. much as it has ever been enforced in Italy. 

It was not until a good many years after that the pro- 
tective \vas put to a real test, on the revival of the small- 
pox epidemics after a rather longer interval than usual, 
which had been more than adequately filled by typhus.^ 
Then the objections to vaccination began to find utter- 
ance, and were answered in the dexterous apologetic 
manner which we know so well. Sacco appeared at the 
Vienna meeting of the German Association of Natural- 
ists and Physicians, on 26th September, 1832, and de- 1 
livered a Latin oration on the need for compulsory 
vaccination all over the world, in which he said that 
al! the objections that can be brought against vaccine 
yield to reason and experience {rationi cedunt atqtta 
experientiis), or, in other words, they yield to professional 
apologetics. On that occasion the famous apology for 
cowpox was brought forward by Sacco, that, if it did not 
prevent smallpox, it reduced its attack to a mild type, 
This was promptly challenged by Schonlein (the future 
leader of German medicine and a man of deep learning, 
who had made epidemics his favourite study), on the 
ground that there had been just as large a proportion of 
mild smallpox cases before the vaccination era as there 
ever was after it. 

' Trallato lii Vncciiiasiotie, p. 18. 

" See Corradi, Annali ddU Epidemie occorse in Italia. 



VACCINAL SYPHILIS IN ITALY. 287 

By a singular fate, those very districts of Northern 
Italy which Sacco provided with an indigenous kind of 
vaccine, milder than the English stock, were the first in 
Europe to be afflicted by epidemics of so-called vaccinal 
syphilis involving the infancy of whole communes at 
once. In my former book on the Natural History of 
Cowpox and Vaccinal Syphilis, I have entered into the 
evidence concerning these and other epidemics of the I 
kind, and have stated the conclusion, which has not 
been as yet impugned, that the so-called syphilitic pro- 
perties of the vaccine were not a contamination of it by 
another virus, but a revival, through carelessness as to 
over-ripeness, etc., of those inherent properties of cowpox 
to which it owed its original colloquial name of a pox. 

While Sacco was the great apostle of cowpoxing in 
Italy, and for some years almost the only vaccinator in 
certain provinces, the new practice took an independent 
start in Piedmont, in association with the Geneva vacci- 
nists, and was carried on by a number of the ordinary 
medical practitioners.^ Professor Buniva, of Turin, a 
leader in all matter.'! concerning natural and medical 
science in their relations to the domestic animals and to 
agriculture, presented a report in 1803, on the protec- 
tive value of cowpox, which I have been unable to 
see. There was also an unimportant variolous test by 
Moreschi at Venice, on 26th August, iSor,'' 

The English emissaries of Jenner had also a hand 
in introducing cowpox into Sicily and Southern Italy. 
Marshall, the Eastington practitioner, whose round per- 

' Buniva, Calendario Georgtco, Xc. 

' Sacco, Osservasioni ^ratiche,iZoJ, p. 219. 



288 



THE JENNER OF ITALY. 



centages are referred to on p. 129, was allowed by t 
Admiralty to go out in the Endyinion in July, \'- 
a mission of his own to vaccinate among soldiers aot 
sailors in the Mediterranean. In the course of the yei 
1 801 he came to Palermo, and was hailed as a delivei 
by the enlightened monarch Ferdinand IV., and 1 
equally enlightened Court. 

"It was not unusual," Marshall wrote home to Jenner,* 
" to see in the mornings of the public inoculation at thej 
Hospital, a procession of men, women, and children, con-] 
ducted through the streets by a priest carrying a crosa^ 
come to be inoculated. By these popular means it met 
not with opposition, and the common people expresse< 
themselves certain that it was a blessing sent frora 
Heaven, though discovered by one heretic and practised 
by another." 

That was the missionary apostolic side of Marshall'^ 
cowpoxing zeal ; but in private circles at FalemMM 
his fee for vaccination was ten guineas in genteel fami- 1 
lies, and five guineas in families of the middle class.'-! 
Palermo had not seen such another enthusiast since I 
the time when it gave to the world Count Alessandra-J 
dl Cagliostro, "healer of diseases, abolisher of wrinkles, I 
friend of the poor and impotent, gold-cook, grand j 
cophta, prophet, priest, and thaumaturgic moralist, etc." 

The Italians have never been very critical of the J 
Jennerian legend, or of any part of the same. An J 
English book that they admire greatly, Mr. Smiles'f 
Self Help, which has circulated in Italy to the extentj 



' Baron, i. 403. 

* Mid. and Pkys. Jotint., 1 



THE JENNERIAN LEGEND IN MARBLE. 289 

of fifty thousand copies, and appears to have given 
its name to a wide-spread association, may have 
had something to do with the more recent develop- 
ments of Italian enthusiasm for Jenner. The author of 
Self Help gives more than two pages of his crowded 
space to that worthy ; he repeats the Jennerian history 
in its usual legendary form, with at least one error 
peculiar to himself Among other things, he tells us 
that Jenner's "faith in his discovery was so implicit that 
he vaccinated his own son on three several occasions." 

Now, one of the most remarkable pieces of recent 
Italian art, which attracted much popular admiration at 
the Paris Exhibition of 1878, is the group in marble, 
by Professor Monteverde, of Rome, described in the 
catalogue as " Edward Jenner che inocula il vaccino al 
figlio." Jenner did vaccinate his own child, Robert F. 
Jenner, aged eleven months, on the 12th of April, 179S, 
after he had vaccinated several ; but, as often happened 
in the first trials, he did not " take. " ^ Shortly after, 
when Jenner was living at Cheltenham, a medical friend 
came into the house, and, taking the child in his arms, 
remarked pleasantly that he had Just left a family in 
the smallpox. "Sir," cried jenner, "you know not 
what you are doing. That child is not protected.'' 
The boy was thereupon inoculated, but not with cow- 
pox ; he was inoculated with smallpox.^ This visit to 
Cheltenham seems to have been in the autumn and 
winter of 1798-99,' when Jenner had no better stock of 
vaccine than the matter from the Stonehouse dairy 



290 THE JENNER OF ITALY. 

which had produced alarming ulcerations both in his 
own trials of it and in the trials by two of the Stroud 
surgeons. That was not the sort of " lymph " which 
Jenner would care to use upon his own son ; and it was 
not until February, 1799, that Woodville provided him 
once for all with a stock which he could use. But this 
is how he explains the incident of using smallpox 
matter on his child. The reason, he says,^ "for not 
resuming my operations [with cowpox] at Cheltenham 
was the supposition that the people assembled at a 
public watering-place might conceive the disease (then 
so little known) to be contagious." Accordingly, when 
his child was suddenly exposed to risk, Jenner saw no 
alternative but immediate inoculation with smallpox, a 
disease which " the people assembled at a public water- 
ing-place " might not merely conceive to be contagious, 
but knew very well to be contagious. Indeed, Jenner 
and his friends were demanding the statutory prohibi- 
tion of smallpox inoculation on that very ground as 
early as 1802. 

The group by Professor Monteverde might just as 
well have been called '* Jenner Pricking a Child," or 
"Jenner Inoculating a Child"; but the professor had 
sought, by the aid of the catalogue, to import an air of 
heroism and magnanimity into an incident which is in 
itself vulgar and trivial, and to that end he had used 
the popular legend of Jenner without critically examin- 
ing it. The story in marble of "Edward Jenner che 
inocula il vaccino al figlio," is of a piece with the whole 
story of vaccination in Italy. 

^ Letter to Baron, 6th November, 18 10, in Life of Jenner^ ii. 48. 



CHAPTER XII. 

ASSENT TO A MYSTERY. 

WHOEVER has had opportunity to look into any 
of the larger and more inspiring problems of 
pathology, such as cancer or tubercle, or into those 
great epidemiological themes, reaching out to ethnology 
on the one hand and to ethics on the other, such as 
yellow fever or even smallpox itself, will be sure to 
feel, all the time he is dealing with vaccination, that he 
has got hold of an exceedingly unworthy subject. One 
naturally seeks, therefore, to dignify it by whatever 
associations may be grouped around it. Its acceptance 
as if by the general assent of mankind is one of the 
considerations that redeem vaccination from the re- 
proach of paltriness : the famous plea oi securus judicat 
orbis terrarum has been put forward for it, if not in 
words yet in effect, by philosophical historians like 
Sir G. C. Lewis, as well as by medical apologists. 
Again, when one discovers that it was urged upon 
Catholic and Protestant parents in homilies given to 
them at the baptism of their infants,^ recommended by 

* Sacco, Trattato^ 1809. Mosele/s Commentaries on the Lues 
Bovilla^ 2nd ed. p. 51. De Carro to Jenner, 14th February, 1801. 
Baron, i. 339. 

29 T 



292 



ASSENT TO A MYSTERY. 



sermons from Anglican and Lutheran pulpits,^ and by 
a ukase of the Czar to the clergy of the Greek Church,* 
we seem to be deaUng with something of the nature of 1 
confiteor unuiii baptisma. And if anything were wanting 1 
to dignify vaccination in its psychology, if not in its 1 
objective characters, we find it in the circumstance that 1 
the general assent to it was admittedly the assent to j 
a mystery. Credo quia imposstbile was as truly the [ 
personal action of men's minds towards the mysterious J 
efficacy of vaccine as it has been towards the arcana of 1 
the faith. 

I am here concerned with the vaccine dogma 
showing forth assent to a mystery ; and my first duty ] 
is to bring forward evidence of the fact. Dunning, a i 
devoted Jennerian who had some pretensions to scholar- 
ship, drew up quite early in the day a Latin definition | 
of vaccine inoculation which begins. Morbus vicar, 
potiusve processus succedaneus, mirifico varioiam certe \ 
prtEveniendi, immo {quod veresimilius sit) penitus I 
abolendi, fungens munere : — a vicarious disease fulfilling | 
the marvellous office of preventing smallpox, etc.* 
When Woodville went over to Paris in iSoo, and first I 
demonstrated the new inoculation there, Dr. Colon i 
wrote:* "Does not this preservative from the usual 1 
disease seem, by its beneficent quality, to be a kind of | 



' Sermon at Great St. Mary's, Cambridge, in 1805; Baron, i 
49. See also Ring's Treatise on the Cowpox, 1S01-3 ; Med, \ 
Chirurg. Zeilung, ii. 399, etc. ; Address to Church of Scotland, 
by the Managers of the Vaccine Institute. Edin., 1803. 

' Letter of Crichton to Jenner, 181 1, in Baron, ii. 184-6. 

' Med. and Phys. JoiirH., iv. 146. 

* Iiid.,iv. Letter of 27th July, 1800. 



THE MVSTEKY CONFESSED. 293 

marvel, when we consider that the trouble it gives rise 
to is nothing more than the puncture which one makes 
for the purpose of inoculating, and is exempt from the 
slightest accident." It is true that Colon was after- 
wards stigmatized by the more academical advocates 
of vaccine in Paris as a charlatan ; but that was mainly 
because he treated vaccination with too little ceremony 
as a matter of business. De Carro, the leader of the 
movement in Vienna, asks in his treatise; "How can 
it be conceived that an effect apparently merely local 
can guard against such a disease as the smallpox, whose 
effects on the whole system are known to us all to be so 
violent? Certainly the fact is very extraordinary ; it is 
a new mystery added to those which, from the beginning 
of medical science, have been deplored by its professors." ' 
To take one more foreign confession, Sacco brings 
forward the common apologetic doctrine of the time, 
that genuine vaccine becomes spurious if a person who 
had gone through the natural smallpox become the 
vaccinifer, and adds: "Those who wish to know the 
reason of everything will want to know the reason of 
that. We need new observations so as to be able to 
rend asunder the veil of this medical mystery," And 
lastly, Jenner himself had struck the keynote of mystery 
in the opening pages of the Inquiry: "But what renders 
the cowpox so extremely singular is that the person 
who has been thus affected is for ever after secure frojii 
the infection of the smallpox." In support of "so extra- 
ordinary a fact," he proceeds to lay before the reader a 
great number of instances. 



I 



294. ASSENT TO A MYSTERY. 

The fact was all the more extraordinary, as Jenner's 
readers quickly perceived, and he himself had pointed 
out,^ in that one attack of cowpox did not prevent a 
second of the same. If cowpox does not protect from 
itself, they asked, how can it possibly protect from 
smallpox ? This only made the mystery more myste- 
rious. Pearson was so well aware of that intellectual | 
difficulty that he promptly denied," and continued to 1 
deny,' the possibility of the same person having cow- 
pox twice. In the very first review of Jenner's Inquiry, , 
in an English journal,* the author's statement that one 
attack of cowpox did not preclude a second or a third 1 
is mentioned as being " received with general scep- 
ticism merely on account of its improbability." Dr. 
Winterbottom, a physician of foreign experience, was at 
a loss to understand how an affection could be constitu- 
tional, and at the same time obscure in its action, or 
"without any evident disturbance of the functions,"* 
A Philadelphia physician wrote to a correspondent In 
England : " I should have inoculated with the matter of ' 
kine-pock two years ago, having received an infected 
thread from Dr. Pearson ; but I was deterred at that J 
time by the fact mentioned by Dr. Jenner, of a person 



■ " It is singular to observe tbat the Con-pox vi 
renders the constitution insusceptible of the variolous, should \ 
nevertheless leave it unchanged with respect to its own action." 
— Jenner's Inquiry. 

' Inquiry on the History of the Coivpox, j 798. 

Report of the Vaccine Pock Institution, 1803, p, 49. 
Med. and Phys.Journ., i. 8 (Jan., 1799). 

Ibid., vi. 1801 (7th June). See also Chapman, in Duncan's 
Annals, 1799. 



THE MYSTERY DISREGARDED. 



295 



being able to be infected with tlie kine-poclt more than 
once, tliough it rendered him for ever secure against 
taking the smallpox,"' 

These intellectual difficulties were soon forgotten. 
The profession were unwilling to admit that there was 
any real mystery. They reasoned : We are practical 
men ; it is not our affair to explain how or why cowpox 
wards off smallpox ; but we know from our experiments 
and our experience that it does so, and that is enough 
for us ; it is only one more empirical truth added to the 
long series of empiricisms of which the medical art is 
made up. As my primary object throughout this book 
has been to show how Jenner got his cowpox doctrine 
and practice accepted in good faith by the medical pro- 
fession and the educated laity all over the world, I am 
not concerned so much with the logic of the case as 
with its psychology; and I do not here enter upon 
such matters as the practical man's blameworthiness in 
declining to- scrutinize with the utmost rigour the terms 
in which a proposition is stated or an experiment con- 
ceived, or his laxity in omitting to apply to his proper 
business that obstetric or Socratic method by which 
ideas are disentangled and illusions exposed. I take the 
assent to the vaccine mystery as a historical fact, and I 
shall now endeavour to show how far it exemplifies the 
working of the mind on one of those mysteries that are 
apprehended as if ubique et ab omnibus, and how far our 
modern scientific instance is peculiar in its psychology. 
Cardinal Newman, in his Grammar of Assent, ^ dis- 



296 



ASSENT TO A MYSTERY. 



3ses the question of belief in a mystery and expounds 
the law of our minds according to which the assent 
is given to it, A mystery, he says, is a proposition 
conveying incompatible notions, or a statement of the J 
inconceivable. We can assent provided we can appre- 1 
hend ; therefore we can assent to a mystery, for, unlessJ 
we in some sense apprehend it, we should not recogniscJ 
it to be a mystery, that is, a statement uniting incom-l 
patible notions. But words which make nonsense da| 
not make a mystery, — such words, for example, 
Walton's line, "Revolving swans proclaim the welkiid 



When we assent to a mystery as such, or in respect ol3 
its myslcriousness, our assent is notional as distinguisheda 
from real. Further, even processes of inference < 
end in a mystery, our notions of things being nevef^^ 
simply commensurate with the things themselves, but] 
aspects of them, more or less exact, and sometimes aJ 
mistake (ib initio. The free deductions from one on^ 
these aspects necessarily contradict the free deductions J 
from another. After proceeding in our investigation i 
certain way, suddenly a blank or a maze presents itself 1 
before the mental vision, as when the eye is confused by W 
the varying slides of a telescope. When we try to! 
explain that the physical tokens of creative skill need! 
not suggest any want of creative power, we feel we ar&a 
not masters of our subject. We apprehend sufficiently! 
to be able to assent to these theological truths 
mysteries; did we not apprehend at all, we should be J 
merely asserting. 

The exposition goes on — To give a notional assent tofl 
a dogma of faith is a theological act ; to give a res 



THE CONDITIONS OF ASSENT, 297 

assent to it is an act of religion. The dogma is dis- 
cerned, rested in and appropriated as a reality by the 
religious imagination ; it is held as a truth by the 
theological intellect. But there is no line of demarca- 
tion between these two modes of assent, the religious 
and the theological. In the Athanasian creed, the 
doctrine so drawn out is plainly of a notional character ; 
is it not also capable of being apprehended otherwise 
than notionallyP Is it a theory, undeniable indeed, 
but addressed to the student, and to no one else ; or 
does it come to the unlearned, the young, the busy, and 
the afflicted, as a fact which is to arrest them, penetrate 
them, and to support and animate them in their passage 
through life; that is, does it admit of being held in tlie 
imagination, and being embraced with a real assent? 
The answer is affirmative. 

Now, the author continues, let us observe what is not 
in that exposition ; — there are no scientific terms in it, 
no terms which do not admit of a plain sense and are 
used in that sense ; they are not abstract terms, but 
concrete, and adapted to excite images ; and these 
words, thus simple and clear, are embodied in simple, 
clear, brief, categorical propositions. There is nothing 
abstruse either in the terms themselves or in their set- 
ting. It is plain, of course, even at first sight, that the 
doctrine is an inscrutable mystery, or has an inscrutable 
mysteriousness. But the mysteriousness of the doctrine 
is not, strictly speaking, intrinsical to it, as it is proposed 
to the religious apprehension, though in matter of fact 
a devotional mind, on perceiving that mysteriousness, 
will lovingly appropriate it. Strictly speaking, the 
dogma, as a complex whole, or as a mystery, is not 



298 



ASSENT TO A MYSTERY. 



I 



the formal object of religious apprehension and a 
but, as it is, a number of propositions, taken one bj^i 
one. A real assent to a mystery is not possible, buti 
only a notional; because, though we can image the] 
separate propositions, we cannot image them 
gcther ; we cannot bring them before us by one act of ■ 
the mind ; we drop the one while we turn to take upl 
the other. Our devotion is tried by the long list ofj" 
propositions which theology is obliged to draw iip, byfl 
the limitations, explanations, definitions, adjustments, 
balancings, cautions, arbitrary prohibitions, which arel 
imperatively required by the weakness of human thoughtT 
and the imperfections of human languages. Suchil 
exercises of reasoning indeed do but increase andfl 
harmonize our notional apprehension of the dogma, butT 
they add little to the lumirousness and vital force witlvj 
which its separate propositions come home to ourl 
imagination; and if they are necessary, as they certainly J 
are, they are necessary not so much for faith as against I 
unbelief. 

The author proceeds : — The dogma is not ordinarily! 
spoken of as a mystery, not even in the creeds ; fori 
these are devotional addresses, in which it would be out.| 
of place to speak of intellectual difficulties. What i 
more remarkable is, that a like silence as to the mys-l 
teriousness of the doctrine is observed in the successivcB 
definitions of the Church concerning it. Thus the great! 
Council of Toledo pursues the scientific ramifications ofa 
the doctrine with the exact diligence of theology, at af 
length four times that of the Athanasian creed ; but weT 

not find either the word " mystery," or any suggestioi\; 
of mys teriousness. The custom is otherwise as regards* 



REIJfilOUS ASSENT AND SCIENTIFIC. 

catechisms and theological treatises ; in them certainly 
the mysteriousness of the doctrine is almost uniformly 
insisted upon. But, however this contrast of usage is 
to be explained, the creeds are enough to show that the 
dogma may be taught in its fulness for the purposes of 
popular faith and devotion without directly insisting on 
that mysteriousness which is necessarily involved in the 
combined view of its separate propositions. 

The summing up is :— Theology has to do with tile 
dogma as a whole made up of many propositions ; but 
religion has to do with each of these separate proposi- 
tions which compose it, arid lives and thrives in the 
contemplation of them. In them it finds the motives 
for devotion and faithful obedience; while theology, on 
the other hand, forms and protects them by virtue of 
its function of regarding them, not merely one by one, 
but as a system of truth. And lastly, if the separate 
articles are so closely connected with vital and persona! 
religion, is there cause to wonder that the creed should 
proclaim aloud the importance of the dogma being 
accepted ? 

It is the object of the treatise from which the fore- 
going illustration has been taken (in the original words 
so far as compatible with condensation), to expound all 
that is natural to the mind in the way of apprehending, 
inferring, and assenting; and the great illustrations 
which are always in the background of the author's 
thoughts are taken to be modes of intelligence, imagina- 
tion, and feeling proper to our nature, exemplifying the 
working of the mind at its best and under the best 
guidance. But the author does not omit to remark 
upon the numerous laxities and aberrations incidental 



300 



ASSENT TO A MYSTERY. 



to our mental constitution : " In this day the subjei 
matter of thought and belief has so increased upon us,l 
that a far higher mental formation is required than ' 
necessary in times past, and higher than we have actually I 
reached, The whole world is brought to our doors every I 
morning, and our judgment is required upon social I 
concerns, books, persons, parties, creeds, national acts, f 
political principles and measures. We have to form our 1 
opinion, make our profession, take our side on a hundred \ 
matters on which we have but little right to speak at all. 
. . . Such are the mistakes about certitude among' J 
educated men ; and after referring to them, it is scarcely 1 
worth while to dwell upon the absurdities and excesses | 
of the rude intellect as seen in the world at large ; as if ^ 
any one could dream of treating as deliberate assents, : 
assents upon assents, as convictions or certitudes, the I 
prejudices, credulities, infatuations, superstitions, fana> I 
ticisms, the whims and fancies, the sudden irrevocable I 
plunges into the unknown, the obstinate determinations, 1 
— the offspring, as they are, of ignorance, wilfulness, | 
cupidity, and pride, — which go so far to make up the J 
history of mankind ; yet these are often set down as.l 
instances of certitude and of its failure." ' 

Having stated in the words of its ablest exponent the^ 
case for assenting to a mystery as a normal act of the I 
mind, and having shown by the last quotation that the I 
author had not so handled the case out of a spirit of 1 
mere optimism, I shall now proceed to inquire how it 
stands with the assent to the scientific mystery which I 
immediately concerns us — whether that also conforms to I 



THE COMPLEX DOCTRINE AND ITS PARTS. 30I 

the conditions of an "indefectible" certitude, or whether 
it may not perchance be one of those prejudices, credu- 
lities, infatuations, superstitions, fanaticisms, whims, 
fancies, sudden irrevocable plunges into the unknown, 
and obstinate determinations — the offspring as they are 
of ignorance, wilfulness, cupidity, and pride^ — which are 
so common in the history of mankind. 

That the vaccine doctrine of protection is held with 
a real assent, or religiously, by vast multitudes of men 
and women is unquestionable ; they believe it to be 
necessary for salvation in one small contingency of 
human life ; and they are so sure of it that they even 
enforce it, or allow it to be enforced upon recalcitrating 
minds. Those who thus hold it are assenting only to 
each of the separate propositions that compose it, and 
not to the complex whole of the doctrine or to the 
mystery of it. The four stock component propositions, 
as laid down by Jenner and maintained by his contem- 
poraries, are stated in concrete terms, and are simple, 
clear, brief, categorical. They arc, that vaccine inocula- 
tion prevents smallpox, that it is itself not contagious, 
that it is unattended by a general eruption like that of 
smallpox, and that it is free from risk. These are the 
original component propositions ; they have merely 
become rather less categorical with the lapse of time. 

The complex whole of the doctrine, the system of 
vaccination truth, is a subject for pathology; and it is 
here that the tirst difference is seen between the vaccine 
mystery and that which has been quoted as a great 
classical example of the terms on which a mystery may 
be assented to, Has pathology pursued "the scientific 
ramifications of the doctrine with the exact diligence of 



302 



ASSENT TO A MYSTERY. 



theology " .' Have its exercises of reasoning 
and harmonized our notional apprehension of tlM 
dogma," even if they have added little to " the luminoiu 
ness and vital force with which its separate proposition! 
come home to our imagination"? Has patholo] 
drawn up a long list of " limitations, c>:planationffl 
definitions, adjustments, balancings, cautions, arbitrarj 
prohibitions " ? Does it " form and protect the separatd 
propositions which compose it by virtue of its functioM 
of regarding them, not merely one by one, but as i 
system of truth ? " 

Pathology has never pursued the scientific ramifica^ 
tions of the vaccine doctrine with exact diligence. Oin 
notional apprehension of the doctrine has not bee^ 
increased and harmonized byany exercises of reasoning 
There is not even a definition of vaccine, in scientlfid 
terms, by reference to which the uniformity of tha 
operation can be assured. Let us bring these state 
merits to a test in relation to the most formal, seriouj 
and responsible handling of the vaccine doctrine, 
handling of it in Parliament. 

The question of giving facilities for vaccination all ovt 
England was first brought before the House of Lordj 
in 1840 by the Marquis of Lansdowne, on the c 
of presenting a petition from the Medical Society ( 
London. The common people had grown dissatisfiet 
with vaccine inoculation, the smallpox epidemics 
having returned, especially in the intervals betweeoj 
periods of typhus ; the people had in some places evei)il 
shown a disposition to go back to the old variolous 
inoculation. The Medical Society, approaching thtj 
House of Lords through Lord Lansdowne, asked that 



THE DOCTRINE ESTABLISHED. 303 

variolous inoculation should be forbidden, inasmuch as 
the revival of smallpox was due to it, both directly 
as a source of contagion, and indirectly as keeping out 
the true protective vaccine. Among other things, the 
Society stated that there was " a perfect identity be- 
tween vaccination and smallpox, although the symptoms 
were different," this having been proved by the success- 
ful inoculation of a heifer with smallpox matter on one 
of the mucous surfaces. 

A bill was accordingly brought in by Lord Ellen- 
borough, providing facilities for vaccination of the poor 
under the Boards of Guardians, and prohibiting variolous 
inoculation, except by medical men. The bill, being 
a private member's, was taken in charge in the House of 
Commons by Sir James Graham, an ex-minister, and was 
passed with the important amendment by Mr. Wakley, 
a medical man, prohibiting variolous inoculation abso- 
lutely, under pain of imprisonment. In these debates 
nothing is more remarkable than tlie unanimous ex- 
pression of belief that vaccine prevented smallpox ; it 
was the real or religious assent to the most important 
of the several propositions of the complex doctrine. 
The attempt to deal notionally with the doctrine as a 
whole, by Lord Lansdowne in quoting the Medical 
Society's statement that there was a perfect identity 
between vaccination and the smallpox, although the 
symptoms were different, served to indicate the existence 
of a mystery, while failing to increase and harmonize 
our notional apprehension of it It was an inchoate 
attempt such as, in the analogous case, even a very 
early or apostolic writer would have thought inadequate. 

The next appearance of vaccination in the legislature 



304 



ASSENT TO A MVSTERV;* 



was in 1853, when Lord Lyttelton, as a prf 
brought in a bill to make vaccination compulsory. Thffi^ 
bill passed through both Houses without oppositional 
and with hardly any debate except on points of detail^ 
Lord Lyttelton was asked to inform a correspondent iii>l 
1869 upon what evidence he had proceeded in framinj 
the first compulsory Vaccination Act, and replied : "Tha| 
expediency of making vaccination universal I took, : 
I believed, on common notoriety, and the medical.V 
authorities 1 chiefly consulted were Dr. Seaton and Dr. 
Marson." ^ In the House of Lords he said, " It is un- 
necessary to speak of the certainty of vaccination as a 
preventive of the smallpox, that being a point on which 
the whole medical profession had arrived at complete 
unanimity." 

The Act of Parliament of 1853 had no section I 
devoted to the "Definition of Terms"; there was no ' 
definition of cowpox or genuine vaccine, an omission all 
the more remarkable that variolous matter was then 1 
being used as vaccine, on the pretext that it had " passed 
through the cow." Although a medical dogma was 1 
therein established by the State, the doctrine was not ] 
formulated. In the other great instance of do; 
established by the State, there was a body of doctrine 
carefully defined in a series of co-ordinate and inter- 
dependent articles: it had been "pursued into its 
scientific ramifications with the exact diligence of theo- , 
logy." The vaccine doctrine, in the Act of 1853, stood 1 
alone, not co-ordinated to any other principle of epidemi- j 



' Letter of Lord Lyttehon to R. B. Gibbs, aSsh July, 
Vaccination Inquirer, iii. ?i. 



A SCIENTIFIC BASIS. 

ology or of pathology; and it was moreover undefined 
in any terms whatsoever. It was simply a notorious 
empirical practice that was established under pains and 
penalties. 

Three years after compulsory vaccination became the 
law of the land, it was thought desirable to meet objec- 
tions that were now beginning to be heard, by an 
elaborate blue-book of history, theory and experience, 
presented to both Houses of Parliament. In that blue- 
book the old fragment of theory adduced by Lord 
Lansdowne in 1840, of the identity of cowpox with 
smallpox, was reproduced with a good deal of formality 
and authority. After stating that Jenner's Inquiry 
of 1798 had set the popular belief "on a scientific basis," 
the Report proceeds ; " It was not until forty years after 
that science supplied an authentic interpretation of 
Jetiner's wonderful discovery, . . . These researches 
[inoculation of smallpo.K upon a semi-exposed mucous 
membrane of a heifer] set in a very clear light the 
meaning of Jenner's practice. A host of theoretical 
objections to vaccination might have been met, or indeed 
anticipated, if it could have been affirmed si.xty years 
ago as it can be affirmed now : — This new process of 
preventing smallpox is really only carrying people 
through smallpox in a modified form. The vaccinated 
are safe against smallpox because they, in fact, have 
had it" (p. xii.). 

This was one of those simple, clear, categorical state- 
jTients belonging rather to the real or religious assent 
than to the notional ; there was nothing here of the 
"exact diligence" of pathology, pursuing the scientific 
ramifications of the doctrine; any such attempt to 



306 ASSENT TO A MYSTERY. 

represent the complex doctrine as a whole would have 
brought men face to face with the mysteriousness of it, 
with the juxtaposition of incompatible notions, with an 
inoculated smallpox which was not smallpox and yet 
prevented smallpox, as had been said in 1840 in the 
very hour when they were making the old inoculation 
a penal offence. 

In the progress of medical science the veil of mystery 
hanging over the vaccine doctrine as by law established 
has not been lifted. On one occasion we seemed for a 
moment to catch sight of the firm outlines of a scientific 
principle, but the vision proved to be an illusion. When 
the Ministry of the day proposed in 18S0 to relax the 
penal provisions of the compulsory vaccination law so 
far as to let a recalcitrant parent off with a single fine 
or imprisonment for each child, instead of fines or 
imprisonments at intervals of six months, more or less, 
until the child was fourteen years old, the project was 
defeated by the strong representations made to the 
Minister by those deputed from the medical and scientific 
corporations. One of these deputations was organized 
by the President of the Royal Society, and consisted of 
himself and Professor Huxley, the President of the 
Royal College of Physicians, the President of the Royal 
College of Surgeons, the President of the General 
Medical Council, and others. The President of the 
Royal Society justified his action in the next annual 
address to the Fellows ; ^ the proposed abolition of 
repeated penalties for non-compliance with the Vaccina- 



* Presidential Address by W. Spottiswoode, Proc, Royal Soc.^ 
3cth Nov., 1880. 



PASTEUR AND JENNER. 

tion law appeared to "trench closely upon the applica- 
tion, at least, of a scientific principle," When asked by 
a correspondent to state what was the scientific principle, 
the President of the Royal Society replied briefly : " The 
principle to which I referred was that of vaccination." ' 

Within a year of that adumbrating of the scientific 
principle of vaccination, a step was taken by M. Pasteur, 
of the Academic des Sciences, to remove the mystery 
by generalizing the word "vaccine" so as to include a 
number of "protectives" which had nothing to do with 
cows or cowpox. At the International Medical Con- 
gress held in London in iSSi, he said :^ "J'ai donne i 
I'expression de vaccination one extension que la science, 
je I'espere, consacrera comme un hommage au merite et 
aux immenses services rendus par un des plus grandes 
hommes de I'Angleterre, votre Jenner." And in another 
of the General Addresses spoken on the same occasion, 
under a title which breathes the severe spirit of scientific 
scrutiny, " Le Scepticisme en Medecine au Temps Passe 
et au Temps Present,"' we read that M. Pasteur, 
"reprenant et systematisant I'ceuvre de votre grand 
Jenner, arrive par I'attenuation methodique des virus, a 
rnaugurer la prophylaxie des maladies virulentes, et 
nous ouvre ainsi des horizons nouveaux et indefinis." 
Here, then, we have the scientific principle ; it is the 
methodical attenuation of virus. Let us examine this 
last word of science upon the empiricism of a former 

' Letter of W. Spottiswoode to G. S. Gibbs, ist Feb., iSSi, pub- 
lished in Vaccinalion Inquirer, m. 12, 

= Address at St. James'3 Hall, Sih Aug., 1S81. Trans. Iniernat. 
Med. Congress, i. 85. 

" Dr. Maurice Raynaud, ibid., p, 51. 



ASSENT TO A MYSTERY. 



age, so as to discover whether we are now quite "i 
with the old juxtaposition of incompatible notions. 

An English exponent of the modern French principle! 
of " vaccin " states the case thus : " You know that's 
vaccine lymph came originally from a cow or a calf.l 
. . The vaccine virus is, probably, a mild form of] 
the most virulent smallpox virus. Pasteur would call itj 
an attenuated virus. Now, he has succeeded in thisl 
process of attenuation so far as to do for other diseasesj 
what Jenner enabled us to do for smallpox. The agent! 
by which the attenuation is effected, Pasteur considers! 
to be the oxygen of the air." ^ 

So far as concerns the attenuation of the most viru-1 
lent smallpox virus, that is an old eighteenth-century I 
practice and theory, of which a full account has been I 
given in chapter vi., on " The Variolous Test," It was 1 
that attenuated smallpox virus which Jenner used, not 1 
as vaccine, but as the test of the power of vaccine against J 
variola. The attenuation was effected by taking thel 
virus from the local pustule of inoculated smallpox! 
instead of from a pustule of the general eruption, and! 
by taking it when it was a serous or ichorous fluidl 
short of the full ripeness of purulent matter. The dis-1 
tinctive character of the cowpox' disease itself, as con-i 
trasted with the purulent eruption, contagiousness, and! 
fever of smallpox, was a different thing ; it had nothing 
to do with the oxygen of the air, but depended on the.fl 

' Professor Tyndall, address at Preston, December, 
his introduction to /,. Pasteur: his Life, elc. (London, 1885), heB 
adds : " He has also weakened it by transmission through var 
animals. It was this form of attenuation which was brought 
play in the case of Jenner." (p. xxxvii.) 



THE DUTY OF PATHOLOGY. 309 

much more intricate process of the transmission of a 
disease from the horse's hocks to become a disease of 
the cow's teats, and thence an artificial disease of the 
child's arm. 

Thus we enter upon a dense and tangled underwood 
of historical origins. If it is ever to be cleared, it will 
need something more of exact diligence than is implied 
in the invention of phrases like the "methodical at- 
tenuation of virus," or the construction of bold figures 
of speech like " vaccins charbonneux," or " vaccins 
rabiques." Science can never divest vaccine of its 
historical associations with a loathsome corroding 
ulceration of the cow's teats, due to the callous barbarity 
of ignorant milkers. 

The exact diligence of theology, pursuing the scientific 
ramifications of its mysterious doctrine to four times 
the length of the Athanasian Creed, must command the 
respect even of unbelievers, the more so as it is a Church 
maxim that salvation does not lie in dialectics. But 
what shall we say of pathology, which has never faced 
its miraculous doctrine at all ; which has not had the 
candour even to recognise the juxtaposition of incom- 
patible notions; which can show no better front to the 
world than a thin tissue of rhetoric or metaphor made 
to do duty as scientific authority ; which shelters itself, 
whenever it can, behind the establishment by law of 
its own doctrine, deliberately left undefined and unformu- 
lated ? 



CHAPTER XIII. 

ESTABLISHMENT AMIDST DISSENT. 

THE first antivaccinist, and one of the most resolute, 
was Dr. Benjamin Moseley, a physician of wit and 
shrewdness, with a large practice among the upper 
classes in St. James's. He had practised for a number 
of years in Jamaica, had done valuable service in the 
military operations as principal medical officer of the 
colony, and had published a standard work on Tropical 
Diseases and the Climate of the West Indies (three 
editions), as well as a treatise on Coffee (five editions). 
On his return from Jamaica, he spent several years iri 
visiting the great Continental schools,^ and on settling 
in London had been appointed by Secretary Grenville 
to the coveted office of physician to Chelsea Hospital, 
which he filled for thirty years " with the greatest 

When Jenner's Inquiry was beginning to be talked of 
in the autumn of 1798, Moseley was on the point of 
publishing a historical and practical essay on Sugar, 
together with some West Indian odds and ends, such 
as an account of the Obi of the negroes, and a narrative 

* Gent, Magaz,, 1790, p. 10. 

2 Munk's Roll of the College of Physicians^ 2nd ed., vol. ii. 368. 

310 



DR. MOSELEY. 31I 

of the last stand and overthrow of Three-fingered Jack, 
the famous negro outlaw of Jamaica, whose Obi-bag he 
had obtained possession of. Along with these mis- 
cellanies he introduced a few remarks on Jenner's novel 
doctrine of cowpox, which appear to have been written 
in September, 1798. At that time none of the journals 
of the profession had spoken ; but Jenner had been in 
London all the summer ventilating his project among 
his friends, and Pearson, a colleague of Moseley's in west- 
end practice, had been taking it up in the most serious 
way, and had by his correspondence stimulated curiosity 
about it, if not even enthusiasm for it. 

Moseley's remarks on the latest medical novelty are 
a curious mixture of jesting and good sense. The 
appearance of the Inquiry is spoken of as a portent in 
the heavens, the significance of which was not altogether 
clear: "Some pretend that a restive, greasy-heeled 
horse will kick down all the old gally-pots of Galen. 
. . . To preserve, as far as in me lies, the genesis of 
this desirable, this excelling distemper to posterity, I 
mention that it is said to originate in what is called the 
greasy-lieel distemper in horses. . . . The virtues of 
this charming distemper are said to be an amulet against 
the smallpox. ... In this cow-mania it is not 
enough for reason to concede that the cowpox may 
lessen, for a timey the disposition in the habit to receive 
the infection of the smallpox ; all cutaneous deter- 
minations, catarrhal fevers, and every disease of the 
lymphatics do the same. . . . The smallpox and 
the cowpox are not analogous, but radically dissimilar. 
. . . Can any person say what may be the conse- 
quences of introducing the lues bovilla^ a bestial humour, 



ESTABLISHMENT AMIDST DISSENT. 



into the human frame after a long lapse of years ? 
The doctrine of engrafting distempers is not yet coiU'^l 
prehended by the wisest men ; and I wish to arrest thq 
hurry of pubHc credulity until the subject has undergoi 
a deep, calm, and dispassionate scrutiny ; and to guardi 
parents against suftcring their children becoming victimw^ 
to experiment." 

The effect of this sensible line of remark was some 
what marred by a few pleasantries or extravagancoi 
about the human form becoming assimilated to that c 
an o.x ; these conceits had merely been suggested hyM 
something from Ovid which had come into his head ;;l 
but the Jennerians took them very seriously, and kept! 
quoting them for many years as examples of the pon-f 
sensical opposition with which a great discovery hadl 
been received. 

Moseley seems to have really expected that his I 
criticism would arrest the hurry of credulity. He had'l 
made the mistake, however, of forming an a priori judg- J 
ment, and had so put himself out of court in thel 
estimation of all stolid Englishmen. Eight years after, f 
when a good deal of experience had been gained, a I 
writer in the Edinburgh Review expressed surprise that I 
Moseley, in 179S, should have declared against cowpox- \ 
ing "on the basis of theory," although at that time "he A 
had neither read nor seen anything that was not j 
decidedly in its favour."^ To this Moseley replied : "It 1 
must indeed seem supernatural to ignorant people that J 
I should, solely on the ground of analogy and pathology, 
have produced a publication foretelling all the horrid:] 



' Editiburgh Rciiiiiu. October, i8c6, p. 42. 



HORSE-GREASE UNPOPULAR. 313 

events which have since taken place." ' He had made 
up his mind upon a scientific book after reading it 
between the lines; he had judged it just as if it had 
been open to scrutiny like a business project, or to 
criticism like a literary production, putting his foot 
down and calling out, as if he had been Dr. Johnson, 
"The thing is a fraud, and there's an end on't." He 
had treated J enner's monstrous grease-of- horse and pox- 
of-cow amulet with no more scientific forbearance than 
if it had been the Obi of Three-fingered Jack, which he 
described in the same volume (the end of a goat's horn 
filled with a paste made of the blood of a black cat, 
human fat, grave dirt, etc.). He took no account of 
Jenner's being a fellow of the Royal Society. 

Moseley did no more than give expression to the 
first thoughts of a good many people in London when 
they heard of the cowpoxing. On the 13th of Novem- 
ber, 1798, Dr. Pearson, who was prepossessed in its 
favour, wrote to Jenner :^ — 

" You cannot imagine how fastidious the people are 
with regard to this business of the cowpox. One says 
it is very filthy and nasty to derive it from the sore 
heel of horses. Another — my God, we shall intro- 
duce the diseases of animals among us, and we have 
too many already of our own ! A third sapient set say 
it is a strange, odd kind of business, and they know not 
what to think of it." 

Dr. Moseley was in a good position for giving currency 



' An Oliver for a Rowhind (roply to Rev. Rowland Hill), loih 
ed., London, 180;, p. 38. 
' Baron, i. 305, 



314 ESTABLISHMENT AMIDST DISSENT. 

to these aspects of the new nostrum. By one means or 
another during the next two years he disposed of two 
or three editions of the volume of essays which con- 
tained his cowpox paper ; and some time after he 
expanded the latter into a considerable volume under 
the title of a Treatise on the Lues Bovilla} illustrated 
by cases of " bad arms," so as to enforce the luetic 
nature of the disease. Having a large connexion in 
literary and political circles, he found many opportunities 
of exercising his wit at the expense of the Jennerians. 
Among his patients was Charles James Fox, who was 
in the way of encountering Jenner at Cheltenham. Mr. 
Fox, it appears, had been ** poisoned " by Moseley 
against the pleasing doctrine of cowpox which Jenner 
had invented, and took occasion to quiz the vainglorious 
discoverer. " Pray, Dr. Jenner," he said, ** tell me of this 
cowpox that we have heard so much about. What is 
it like ? " Jenner answered, in his favourite figure, that 
it was like "a pearl upon a rose leaf;" whereat the 
statesman laughed heartily and praised the simile.^ 

Moseley was almost the only medical man during the 
first two or three years who came forward publicly as 
an uncompromising opponent. We read also in a letter^ 
of Jenner s, dated iSth July, 1800, that "a man of the 
name of Brown has made a variety of efforts to write it 
down ; but finding himself deserted by every medical 
man of respectability, he shot himself a few days ago." 
Two others besides Moseley were called as adverse wit- 

* 2nd ed., 1805. Munk gives the date of the first edition as 
1 801, but it is also assigned to 1804. 
'^ Baron, ii. 305. 
' Jenner to Rev. John Clinch, of Newfoundland. Baron, ii. 324. 



A LULL IN THE CONTROVERSY. 

nesses before Admiral Berkeley's Committee in May, 
1802, — John Birch, surgeon to St. Thomas's Hospital, 
and Dr. liowley, a voluminous writer of semi-popular 
books who had a large following among the public. 
But neither of these wrote against vaccination until a 
later date ; and their evidence before the Committee, so 
far as it is reported, was not weighty. The parliamen- 
tary vote of ten thousand pounds in 1802 had the effect 
of stopping all cavilling for a time, so that there came 
about that appearance of general assent which I have 
spoken of in a former chapter. Beddoes, at one time an 
opponent, was the first to write that the vote was too 
little, and to suggest a national subscription.^ Cooke, 
who put on record some very damning evidence at the 
outset, had previously written to say that he " had 
opposed the practice with more zeal than prudence."- 

Apart from a remonstrance by Cobbett in the Politi- 
cal Register in 1803, addressed to VVllberforce, who was 
moving to get variolous inoculation put down by law 
and cowpoxing substituted for it, the controversy slum- 
bered until the spring of 1804. The first enthusiasm for 
the new protective had died away ; Jenner's attempt to 
establish himself in consulting practice in Hertford 
Street, Mayfair, had been a disastrous failure, very few 
seeking to employ him as a vaccinator. Both the pro- 
fession and the public were in a cooler mood. The 
more fanatical Jennerians were sanguine, after the vote 
in Parliament and the enthusiastic testimonies from 
abroad, that smallpo.t would soon be exterminated. 



' Med. and Phys. Jou 
^ Ibid., 29th May, i& 



iii. 7UthJune, 1801). 



3l6 ESTABLISHMENT AMIDST DISSENT. 

About the year 1803 they were talking actually of 
burning^ down the London Smallpox Hospital, or of 
selling it for another use.^ They knew so little of the 
very rudiments of epidemiology, or had so lost their 
heads, that they mistook one of the ordinary lulls of 
epidemic smallpox for its total disappearance before the 
cowpox protective, which had been applied to a mere 
handful of the infancy and childhood of the country. 
But it would be a mistake to ascribe these extravagant 
enthusiasms to more than the immediate following of 
Jenner. In the profession at large the craze was over; 
and the outbreak of a new epidemic of smallpox in 
1804 gave an opportunity to the more candid and inde- 
pendent medical men to apply to the evidence that 
reasonable and common-sense scrutiny of which we find 
hardly any trace in their first reception of it. 

The epidemic of 1804-5 was severely felt both in 
London and in various parts of the country, including 
Wales and Scotland. The Smallpox Hospital, happily 
preserved from demolition, soon filled with patients and 
continued full for tnonths. The sprinkling of vaccinated 
children in the population at large were now for the first 
time (in England, at least) subjected to the real trial of 
epidemic contagion. The result must have been the 
same that has often been experienced and accurately 
recorded on a larger scale in later times ; but for that 
epidemic, there is little record of it left beyond the 
evidence that widespread doubt and delusion as to the 
new protective had arisen in the professional mind. 
The publication of six cases at Portsmouth set the 

* H. Eraser, Med, and Phys, Joum,, 1805, p. 33. 



AN ALARMING PAMPHLET. 317 

whole controversy once more in a blaze, producing an 
effect which can only be accounted for by supposing 
that many more had the same experience, although they 
said nothing. Those who did send cases to the medical 
journals in the next few months were two or three well- 
known Jennerians, who knew how to account for the 
failures. 

The cases read and discussed before the Medical 
Society of Portsmouth,^ on 29th March, 1804, were not 
different from hundreds that had occurred in 1799 and 
1800, either in England or on the Continent; only the 
enthusiasm was now over, and reason once more held 
sway. Four of the cases were common instances of the 
variolous test producing the restricted effects of inocu- 
lated smallpox, on being applied a year or two after 
vaccination. These cases had been in Mr. Goldson's 
possession for two years, and he had actually sent up 
one of them to Admiral Berkeley's Committee in 1802. 

It was in March, 1S04, that he was startled into farther 
reflection and decisive action. He was called to see a 
child, vaccinated by himself a year or two before, and 
found it sickening for some kind of eruptive fever. The 
illness proved to be smallpox, and Goldson at once 
invited the leading practitioners of the locality, including 
the surgeons of the Navy at Haslar Hospital, to satisfy 
themselves by inspection of the child and by inoculating 
with the matter. A similar case occurred in his practice 
within a week or two of the other. A very full meeting 
of the Portsmouth Medical Society was held on the 

' Cases of Smallpox subsequent to Vacdnatioit. Hy William 
GoUson, M.R.C.S. Portsea, 1804. 



3l8 ESTABLISHMENT AMIDST DISSENT. 

29th March, which was prominently noticed in the local 
newspaper of the 2nd April, with the further announce- 
ment that Goldson would shortly publish the affair. A 
copy of the newspaper was sent to Jenner, who wrote to 
Dunning (of Plymouth Dock) :^ " What a set of block- 
heads ! How will our Continental neighbours laugh ! " 

Goldson advertised his forthcoming pamphlet in the 
Medical Journal (and probably elsewhere) under a title 
that was then considered alarming, ** Cases of Smallpox 
Subsequent to Vaccination " ; Jenner declared that the 
advertisement was infinitely worse than the book, and 
called it the " murderous harbinger." The book caused 
great excitement, and produced an effect ludicrously 
disproportionate to anything either novel or weighty 
that it contained. It is hardly surprising that Jenner's 
first feeling should have been, ** What a set of block- 
heads ! " All this pother was about four failures of the 
variolous test, and about two vaccinated children who 
had taken the smallpox in the natural way. Why, the 
old volumes of the Medical Journal contained scores 
of cases of both kinds, while the foreign journals con- 
tained accounts of whole epidemics among the vac- 
cinated. But it makes all the difference whether these 
things happen during the hot fit or during the cold. 

Goldson's pamphlet appeared in June, and the 
Medical and Physical Journal published a long abstract 
and review of it in the number for July. The author's 
concluding sentence had evidently touched the editor 
to the quick : " To suffer zeal for the discovery, to shut 
their eyes to conviction, and, by deeming every failure 

^ Letter of 5th April, 1804, Baron, ii. 337. 



THE ANSWER TO GOLDSON. 319 

spurious, to conceal it, is beneath the dignity of the 
profession." The tone of the review is most respectful, 
and gave great offence to Jenner, who wrote to Dunning, 
on the 22nd of the same month : " I am sorry to say I 
cannot send you advertisements to the cover of the 
Medical Journal, The review of G.*s book will tell you I 
have no interest there." The reviewer had said : " The 
entire pamphlet claims an attentive perusal from all 
partisans, friends, and well-wishers of Dr. Jenner's dis- 
covery. . . . The objections of Mr. Goldson, if valid, 
would lead to the entire abolition of vaccine inoculation 
from the human subject. . . . The author, aware of 
the permanent value of vaccination immediately from 
the cow, makes an exception to this species of cowpox." 
The italics are in the original, and they must have given 
Jenner a cold shiver when he saw them. 

The controversy was taken up by Jenner's ever- 
zealous henchman, John Ring, who published an answer^ 
in July, dealing primarily with Goldson, and at the 
same time accusing the Medical and Physical Journal, 
on account of its full analysis and respectful criticism 
in the July number, of " prostituting its pages for the 
purposes of a party." Ring's treatment of Goldson, who 
was highly respected at Portsmouth, and was known in 
the service for his book on maritime discoveries, pro- 
duced general indignation throughout the profession ; 
Jenner himself thus wrote of it to Dunning:^ "Ring, the 
moment he read Goldson*s book, instantly charged his 



^ An Answer to Mr. Goldson, proving that Vaccination is a 
Permanent Security, London, 1804. 
^ 23rd Dec, 1804, Baron, ii. 25. 



320 



ESTABLISHMENT AMIDST DISSENT. 



blunderbuss and fired it in the face of the author." Tb|f 
picture would be complete if it showed Jenner syin4 
pathetically watching the highway ruffian from behma^ 
a hedge. Both Goldson and i\\s Medical Joiinial wer^ 
coerced. The efl'ect of Ring's bullying becomes abun4 
dantly evident in the successive numbers of the journay 
which he dominated for some time after so far as c 
cerned the kind of vaccination papers that were suffered] 
to appear in it.' The editor deplored, indeed, the rough« 
ness with which Goldson had been handled ; whilffl 
Goldson himself, in a second edition, showed a forgiving 
and meek spirit. "Our readers," the reviewer again 
wrote, "will perceive with pleasure a prospect of rccon< 
cilingMr. Goldson to vaccination." '^ 

The effects among the profession at large, and among^ 
the public, were more lasting. Letters appeared in thfll 
Times, Morning Chronicle, Sun, and other newspapers^ 
and in magazines. Jenner wrote to Dunning: " Gold^ 
son's book has sent many a victim to a premature 
grave " ; and again, " Never mind ; you will hear enougHj 
of smallpox after cowpox. It must be so. Ever] 
bungling vaccinist [no word now of the ladies and thaj 
clergymen who had vaccinated their thousands with his) 
cordial approval] who excites a pustule on the arm willI 
swear, like G., it was correct, without knowing thei~ 
nicety of distinction which every man ought to know] 
before he takes up the vaccine lancet." The plates t* 



■ In 1814 Ring complains Ihiit Ihe .Ifo/'. and Phys.Jonrn. ' 
staunch enough to the Jennerian cause. He afterwards w 
the Medical Repository, which was started in that year. 

^ Med.attdPkvs.jQum.,xC(\.{_\%oi),-^. 268. 



CONFIDENCE SHAKEN. 32 1 

show these nice distinctions, which were loudly de- 
manded by the profession and were publicly declared to 
be under hand by an engraver who was called before 
Admiral Berkeley's Committee to speak to the point, 
were never published, for the sufficient reason that 
*• spurious " vaccine was anything one pleased. To 
Dunning, again, he writes: "Vaccination never stood on 
more lofty ground than at present. I know very well 
the opinion of the wise and great upon it, and the 
foolish and the little I don't care a straw for. Why 
should we fix our eyes on this spot only ? Let them 
range the world over. . . . There I have honour, 
here I have none." Truly the eyes of a fool are in the 
ends of the earth. 

Even Dunning himself was shaken in his faith. He 
had written that the Portsmouth cases had an "ugly 
look," a very natural view for him to take, considering 
that his logical statement of the case, when general 
assent was reached in 1802, had been: "The genuine 
vaccine lymph does or does not possess an absolute 
preventive power against variolous contagion. Such 
power is or is not a law of Nature. The protection, if 
it affords protection, cannot be casual, it must be regular 
and determined."^ Those who wish to understand the 
mixture of bullying and wheedling which always charac- 
terized Jenner's conduct of .his business will find a fair 
sample of it in his letters to Dunning, while the Ports- 
mouth affair was troubling the mind of his faithful cor- 
respondent at Plymouth Dock! 

The shock to the credit of cowpoxing in 1804 was 



^ Med. and Phys, Journ.y vii. (1802), p. 3. 



322 ESTABLISHMENT AMIDST DISSENT. 

promptly followed up by a whole series of attacks from 
the side of the old inoculation party, with whom Moseley 
was now identified. During the next year or two, Birch, 
Rowley, Squirrel 1, and Lipscomb published their books 
and pamphlets; while Moseley brought out a new edition 
of the Lues Bovilla, and a volume of commentaries, to 
which Sutton and others contributed cases of smallpox 
occurring after vaccination, either through contagion or 
by inoculation. Goldson*s book was thus the signal for 
a much more determined opposition than anything that 
cowpoxing had called forth in the first years of its trial. 
Jenner was equal to the occasion. Although his 
attempt to establish himself in practice in Mayfair had 
been a failure, yet he was able to say : " I know very 
well the opinion of the wise and the great upon it;" 
and to the wise and the great he now turned. One of 
his patrons was Lady Crewe, who got Lord Henry Petty 
(afterwards Marquis of Lansdowne) to meet Jenner 
at her Hampstead villa, in the summer of 1805.^ The 
result of this conference was that **his lordship resolved 
to bring something forward in the ensuing session." 
Jenner again saw Lord Henry in the early part of 1806, 
and found that " his ardour in my cause had suffered no 
abatement." On the 2nd of July, Lord Henry, who had 
meanwhile become Chancellor of the Exchequer on the 
death of Pitt, moved an address to the King "that his 

• 

Royal College of Physicians be requested to inquire 
into the progress of vaccine inoculation, and to assign 
the causes of its success having been retarded throughout 
the United Kingdom." He took occasion at the same 

* Baron, ii. 55 



COLLEGE OF PHYSICIANS CALLED IN. 323 

time to express his strong conviction that the report 
of the College would be corroborative, which was ex- 
ceedingly probable, considering how the leaders had 
nearly all committed themselves by their evidence in 
1802. 

The appeal to medical authority, as represented in 
its most dignified form by the College of Physicians, 
was the turning-point in the vaccination controversy. 
All that was academical and respectable was henceforth 
ranged on one side, against all the free-lances, lay or 
medical, on the other. The columns of the established 
medical journals were now less open to adverse facts and 
reasonings. In 1806^ a new serial was started, called 
the Medical Observer ; or, London Monthly Compendium 
of Medical Transactions, by a society of practical phy- 
sicians, which became identified with the opposition to 
cowpoxing, and carried on the contest until 181 1, if not 
longer.^ The opposition was naturally most active in 
the metropolis. " It is about London," Jenner wrote 
on 2 1 St February, 1806, " that the venom of these deadly 
serpents chiefly flows."* 

The College of Physicians set to work to collect evi- 
dence on the benefits of vaccination, calling in the aid 
of the College of Surgeons, and of the medical corpora- 
tion in Edinburgh and Dublin. There was a small show 



* The first number was on "Advertised or Empirical Medicines," 
1806 ; title in Watts' Bibliography, 

^ It is perhaps evidence of its want of repute that no volumes 
of it have found their way into the library of the Medical and 
Chirurgical Society, or of the College of Surgeons, or of the British 
Museum. 

' Letter to Dunning, in Baron, ii. 



324 ESTABLISHMENT AMIDST DISSENT. 

of adverse facts, but these were counterbalanced by the 
" respectability," as the report has it, of the testimonies 
in favour of vaccine. Jenner himself appeared before 
the College committee on the 19th of February, 1807, 
with a bundle of foreign diplomas and honours, begin- 
ning with that of the Gottingen Academy of Sciences, in 
1 801, which had been granted under the circumstances 
noticed in chapter ix. The report had to take notice, in 
common fairness, of the adverse evidence ; and it stated 
plainly that "the public had been misled " by Jenner's 
famous doctrine of spurious cowpox in the cow, "as if 
there were a true and a false cowpox." But they were too 
late ; the mischief had been done. They forgot that the 
whole of the early adverse evidence, which ought to have 
stopped the delusion at the outset, had been overruled 
and explained away on that very plea, as I have shown 
in previous chapters. The report concluded that "the 
security derived from vaccination, if not absolutely per- 
fect, is as nearly so as can perhaps be expected from 
any human discovery." 

This report was issued on the loth of April, 1807, 
and was signed by Sir Lucas Pepys, the president of 
the College. On the i6th of May, Jenner wrote from 
Bedford Place, London : "I have just received a note from 
the president. Sir Lucas Pepys, requesting me to vac- 
cinate his little grandson. Two years ago the worthy 
president would as soon have had the boy's skin touched 
with the fang of a viper as the vaccine lancet. But this 
inter nos!' ^ As this worthy person did more than any 
one to get vaccination established, and most of all to 



^ Letter to Dunning, Baron, ii. 357. 



SIR LUCAS PEPYS. . 325 

get it endowed by the State, it will be necessary to say a 
few words about him. 

Dr. Pepys, having made a success as a young man in 
fashionable practice at Brighton, and married a lady of 
title (Countess of Rothes), was called to attend King 
George III. in his severe illness of 1788 and 1789. For 
his services on that occasion he was appointed in 1792 
physician-in-ordinary to the King, and promised the 
office of physician-general to the army when that office 
should fall in, which it did in 1794. In the latter year the 
army medical board was started, consisting of the surgeon- 
general, the inspector-general, and Sir Lucas as president. 
In that capacity he exercised much patronage and 
authority, having in his gift the appointment of all the 
physicians to the forces. Sir Lucas made his appoint- 
ments from the ranks of civil life, without regard to 
previous service in the army, but with a strict regard 
to the privileges or monopoly of the Royal College of 
Physicians. The army medical board, which had already 
lost the confidence of all who knew anything of medicine 
and surgery in the field,^ at length collapsed, on the 
disgraceful state of sickness among the troops in Wal- 
cheren becoming known. Sir Lucas was ordered to 
proceed to Walcheren, but boldly declined, on the ground 
that he " was not acquainted with the diseases of soldiers 
in camp or in quarters." It was difficult to retain his 
services after that ; but a grateful country softened his 
dismissal by a liberal pension, which he enjoyed to the 



* See the pamphlets by McGrigor and Jackson, Scottish gradu- 
ates, on the one side, and Bancroft, a creature of the College, on 
the other in 1808. 



326 ESTABLISHMENT AMIDST DISSENT. 

ripe age of eighty-eight He was a person of great 
firmness and determination, "somewhat dictatorial in 
his bearing, and formed to command."^ He contributed 
nothing to the literature of his profession, except a 
preface to a drug- book. 

This was the estimable public servant who presided 
over the deliberations of the College of Physicians when 
Jenner made his appeal to academical authority. Sir 
Lucas Pepys may have had his little hesitations about 
Jenner and his cowpox ; but it was another thing 
altogether when Lord Henry Petty moved the Crown to 
invite the College over which Pepys presided to deliver 
judgment. The practical part of the business behind 
the scenes was still more congenial to Sir Lucas's tastes. 
Jenner was to have ten thousand pounds additional 
voted to him (amended in the House of Commons to 
twenty thousand), and vaccination was to be endowed 
with an annual vote of at least three thousand pounds, 
the patronage to be vested in the College of Physicians 
and (in a minor degree) in the College of Surgeons. 

The vote to Jenner was moved by the Chancellor of 
the Exchequer (Spencer Perceval) on the 29th of July, 
1807, and carried as amended to twenty thousand pounds. 
That was considered enough for one year, more especially 
as the populace were in a malcontent mood. John Gale 
Jones, a radical leader, and himself a medical man, 
"had the impudence," as Jenner wrote, ^ "to desire a man 
to call on me in Bedford Place, to say that he, Jones, 
would advise me immediately to quit London, for there 

^ Munk's Roll of the College of Physicians^ 2nd ed., ii. 305. 
- Letter to Moore, 26th Feb., 1810, in Baron, ii. 367. 



RIGHT HON. GEORGE ROSE. 327 



>> 



was no knowing what an enraged populace might do. 
The opposition was now at its height outside the .aca- 
demical circle, and was diligently encouraged by the 
inoculators to serve their own ends. 

Sir Lucas Pepys held over until next session the rest 
of his practical proposals for rescuing vaccination from 
its difficulties. Meanwhile, he set Mr. George Rose, 
Treasurer to the Navy, who must have known all about 
places and patronage,^ to prepare the way for the scheme 
of endowing a number of administrative and executive 
vaccination offices. Rose wrote to Jenner in the winter 
and asked him to draw up a plan, with an estimate of 
the annual cost ; Jenner in due course sent the plan to 
London, and followed in person to see matters through. 
He spent five months in town on the second of two 
visits for that purpose, and had interviews with Rose 
and Pepys.^ His advice had been politely asked, but it 
was not followed. 

The scheme, as proposed by Rose to the House of 
Commons on the 9th of June, 1808, was for a National 
Vaccine Establishment, to be administered by the 
College of Physicians and the College of Surgeons. 
The proposal gave rise to a debate, in which the appeal 
to constituted medical authority carried the day, as it 
always does, sixty voting for the Establishment and five 
against. 

The most notable speech was made by Sir Francis 
Burdett, who characterized vaccination as "a failing 
experiment," and warned the House not to " prop up 



* See The Works of Rev. Sydney Smithy popular ed., pp. 173, 231. 
' Baron, ii. 117. 



328 ESTABLISHMENT AMIDST DISSENT. 

what might prove to be pernicious error." ^ Cobbett, 
who must have known something of cowpox in the 
country, and believed the Jennerian doctrine to be 
pernicious error, protested strongly, in the Political 
Register of i8th June, against this interference of 
authority in a matter which ought to be left to the 
common sense of the country. 

This new business, quietly arranged by official persons 
with that belief in themselves and in each other which 
their position creates, roused the opponents of cowpox- 
ing to more strenuous efforts. The walls of London 
were placarded, says Baron, with falsehoods ; " and 
doubtless many a victim perished at the shrine of this 
Moloch." The opposition had become so inveterate, and 
was so inexplicable to that historian on any ground 
of reason, that he is " compelled to believe there is 
a principle in our nature which has too strong an 
affinity for what is untrue." The columns of the 
Independent Whig contained long letters by anti- 
vaccinists ; a debate on the question was protracted for 
several nights at the Westminster Forum ; and a new 



* These are the words as given by Baron. In the Parliameiitary 
Debates^ Sir Francis is reported to have said : " There was some 
danger that we might be fostering a very fatal mistake. Before 
tying the House down by a resolution, it would be well to appoint 
a committee to inquire into the efficacy of vaccination." Lord 
Henry Petty commended the proposed establishment for its " in- 
vestigating " function ; it was " highly proper that investigation 
should be made under the eyes of the public." Mr. Secretary 
Canning " could not figure any circumstances whatever that could 
induce him to follow up the most favourable report of its infallibility, 
which might be brought forward, with any measure of a compulsory 
nature." 



NATIONAL VACCINE ESTABLISHMENT. 329 

journal, called the Cowpox Chronicle, or Medical Reporter, 
was started, and distributed through the post. But the 
year 1808 was not a favourable time for the instinctive 
dislikes of the people being skilfully diagnosed and 
rationally treated ; the more heroic methods of driving 
discontent below the surface were still in vogue. 

Having received the warrant for the National Vaccine 
Establishment in October, Sir Lucas Pepys set to work 
to constitute it. There was to be a Vaccine Board of 
eight, composed of himself as president, with the four 
censors of the College of Physicians, and the master and 
two senior wardens of the Corporation of Surgeons, 
each at an annual salary of a hundred pounds. The 
ostensible ground of this corporation job was that there 
was to be instituted " a full and satisfactory investigation 
of the benefits or dangers of the vaccine practice." 
Jenner was excluded from an active share in the work 
for the obvious reason that he was incapable of the 
judicial temper. However, it was arranged that he 
should be named director. He fought hard to retain 
his hold against the usurpation of the two medical 
corporations, and brought evidence from Paris that the 
corresponding administration by the Faculty there was 
unpaid. Sir Lucas Pepys reassured him, *' You, sir, are 
to be whole and sole director. We are to be considered 
as nothing ; what do we know of vaccination ? " But, 
when the working or executive offices came to be filled 
up, Jenner*s nominees were nearly all set aside, and 
he resigned the office of director. Sir Thomas Bernard 
wrote to him on 6th March, 1809: "From some circum- 
stances which came to my knowledge in November, 
I guessed that the new Board was to be made an 



330 



ESTABLISHMENT AMIDST DISSENT. 



instrument of patronage; I therefore did not argue well 
of the result." ' The best-paid official was called the 
registrar ; and Dr. Hervey, the registrar of the College 
of Physicians, physician to Guy's Hospital, was ap- 
pointed to the office. The Vaccine Board was one of 
the scandals investigated on the motion of Joseph Hume 
in 1827, and was farther reduced by the reformed parlia- 
ment in 1833; the select committee found that the 
members had attended casually, and had left the work 
of "investigation" in the hands of the Executive. For 
the first two years the vaccinations done by it in Lon- 
don were at the rate of two pounds a head. Walker's 
institution, supported by voluntary contributions, did 
most of the vaccinating that was done. 

The National Vaccine Establishment, although 
Jenner was excluded from it, was really the best defence 
of his "failing experiment" that could have been de- 
vised. From the day of its starting, it was never any- 
thing but an instrument of thorough-going vaccination 
apologetics. In iSii a new epidemic of smallpox 
brought the question again prominently under public 
scrutiny, and fashionable society was startled by the 
case of the Hon. Robert Grosvenor, son of Earl 
Grosvenor, who acquired confluent smallpox, although 
he had received the vaccine protection as an infant 
1801 from Jenner's own hands. As Jenner truly said, 
this famous case was "a speck, a mere speck on the 
page which contains the history of vaccine discovery " ; 
but the page was getting a good deal speckled over and 
obscured, witness the numerous cases published in 1809 



I 



AID PROMISED BY COLERIDGE. 33 1 

by Thomas Brown, of Musselburgh.^ The Vaccine 
Establishment issued a special report on the Grosvenor 
case, of a reassuring tenour ; the boy would have died 
outright had he not been vaccinated, despite the best 
skill of Sir Henry Halford and Sir Walter Farquhar. 

The attacks of the anti-vaccinists became so resolute 
in 181 1 that Jenner was seriously urged to institute an 
action for libel. Among those who rallied to his support 
was Samuel Taylor Coleridge, who wrote ^ to him from 
Hammersmith on 27th September, 181 1, that he purposed 
inserting in the Courier a series of papers on the incep- 
tion of the cowpoxing idea in Jenner*s mind and its estab- 
h'shment as a great truth. He added : " The only painful 
thought that will mingle with the pleasure with which I 
shall write them is that it should at this day, and in this 
the native country of the discoverer and the discovery, 
be even expedient to write at all on the subject." He 
announced also that, after long thinking over it, he had 
planned to write a poem on Vaccination, as being a 
subject well suited to exemplify Milton's canon that 
poetry should be simple, sensuous, and impassioned. It 
would have been interesting to see wherein a poem on 
Cowpox would differ from the old prize poem, criticised 
by Coleridge, which began, " Inoculation, heavenly 
Maid ! " But neither the papers in the Courier nor the 
projected poem were ever published. It was of more 
use to Jenner to be able to inform the world that he had 
been chosen, on the 13th May, 181 1, a foreign associate 



* Inquiry into the Antivariolous Power of Vaccination, Edin- 
burgh, 1809. 
' Baron, li. 175. 



332 ESTABLISHMENT AMIDST DISSENT. 

of the Institute of France, on the occasion of the vaccine 
protective being administered to the King of Rome. 

Although vaccination had now a powerful corporation 
interest behind it, its public credit was much impaired, 
and it received no very hearty support from the pro- 
fession outside the circle of officials. Even Pearson, one 
of its earliest and most enthusiastic votaries, would seem 
to have lost faith in it, if we may trust a letter of 
Jenner's (i8th November, 1812), in which he speaks of 
Pearson's " insinuations that vaccination is good for 
nothing." ^ Woodville, the real author of vaccination 
practice, had made no public defence of it after the first 
years, and had subsequently carried on variolous inocu- 
lation side by side with it at his hospital ; he died on 
26th March, 1805, and as he was an honest man, we may 
say of him that he was taken away from the evil to 
come. 

The old variolous inoculation had revived so much 
that Lord Boringdon, at the instance of the Vaccine 
Board, brought a bill into the House of Lords, in 18 13, 
to restrict the practice to secluded areas (the law in 
Vienna since last century), and to get vaccination 
substituted for it among the poor. The bill was suc- 
cessfully opposed by Lord Chancellor Eldon, and by 
Chief Justice Lord Ellenborough, — by the latter on 
the ground that the common law was able to deal with 
smallpox inoculation as a nuisance and public danger, 
and that the bill was narrower in its operation than the 
common law. Lord Ellenborough took occasion to say 
that vaccination did not merit the high encomiums 

* Baron, ii. 383. 



LORD BORINGDON'S BILLS. 333 

passed upon it, and that he did not believe the protec- 
tion to be lasting, although he believed it was a good 
thing.^ This was the blow that Jenner felt most keenly. 
According to Baron, he was greatly annoyed. In a 
letter of that year he writes : ^ " And if the first Lord in 
Parliament should offer to degrade vaccination by utter- 
ing an untruth, as one of these dignified personages, 
lately did," he would still, etc. The biographer couples 
Ellenborough's qualified approval with the popular 
prejudices of the day, and observes that the anti- 
vaccinists must have been proud of the Chief Justice's 
co-operation. 

On the 23rd June, 18 14, Lord Boringdon brought in 
a new bill, with clauses for the compulsory notification 
of smallpox, and, in effect, for the compulsory vacci- 
nation of the poor. He accused Lord Ellenborough of 
having excited an injurious degree of alarm in the public 
mind, declared the assertion of mere temporary protec- 
tion to be erroneous, and an error that they ought to do 
everything to counteract. The bill went through com- 
mittee ; but, on the report, it was vigorously opposed 
by Lords Stanhope, Mulgrave, and Redesdale, and was 
withdrawn. Lord Stanhope ridiculed it, and said that, 
if passed, it would prove " one of the most trouble- 
some, inconvenient, and mischievous measures ever 
enacted." Lord Mulgrave said : " If their lordships 
recollected how many persons of the higher order were 
reluctant to introduce vaccination into their families, 
it really must appear to them a harsh and arbitrary 



1 Parliamentary Debates, House of Lords, 30th June, 1814. 

2 Letter to Moore, 27th Oct., 1813, in Baron, ii. 389. 



334 ESTABLISHMENT AMIDST DISSENT. 

measure to lay the poor under the necessity of adopting 
the practice.** Lord Redesdale thought that, if vaccina- 
tion deserved to be estabh'shed, it would establish itself 
by its own merits.^ 

Another severe epidemic of smallpox in 1817, 18 18, 
and 1 8 19, extending to many places in England and 
Scotland as well as on the Continent, made the Jen- 
nerian cause to look more hopeless than ever. This 
was the first occasion on which medical opinion abroad 
showed signs of wavering. In Scotland, according to 
Dr. John Thomson,^ more of the vaccinated than of the 
unvaccinated were attacked by the epidemic ; but that 
circumstance, unpromising though it looked, was made 
to serve the glory of vaccination. The epidemic of 
smallpox had a distinctive type, as epidemics of other 
diseases besides smallpox are apt to have from time 
to time ; students of Sydenham will find numerous 
instances of the type being modified from season to 
season, while Haser*s volume on the History of Epidemic 
Diseases^ abounds in illustrations of that familiar fact 
in the natural history of disease. The type in the 
Scotch epidemic of 18 18-19 was not new in the history 
of smallpox ; it corresponded closely to the variety 
mentioned by Adams in 1795 under the name of 
"pearly" smallpox, and it was by no means unfamiliar 
in pre-vaccination times. This was the prevailing type 
of the eruption in the epidemic in Scotland, both among 

1 Parliamentary Debates, House of Lords, 8th July, 1814. 

2 Account of the Varioloid Epidemic in Scotland^ with Observa- 
tions on the Identity of Chicken Pox with Modified Smallpox. 
Edinburgh, 1820. 

3 Vol. iii. of his Geschichte der Medicin^ 3rd ed. Jena, 1882. 



SMALLPOX MODIFIED IF NOT PREVENTED. 335 

the vaccinated and the unvaccinated. But, whether 
from forgetfulness of the old types assumed by small- 
pox, or from inability to reason correctly upon the facts, 
or from an overmastering desire to find excuses for the 
cowpox protective, the variety of the disease was now 
described as a modification due to the previous cow- 
poxing of the constitution. Cowpox, it was argued, 
does not indeed prevent smallpox, but it modifies its 
type ; witness this whole epidemic, in which the eruption 
is less purulent, harder, and more pearly. 

This was the real origin of the famous doctrine of 
smallpox " modified," if not averted, by vaccination, 
which is a favourite apologetic plea of our own time. 
Modified smallpox, or varioloid, or "varicella" in the 
sense of the Vienna school, is merely mild or discrete 
smallpox, usually of the common pustular type, which 
was as frequent in the days before cowpoxing was 
practised as it has ever been since. Vaccination in 
1818 stood in great need of some excuse for failure ; 
hence the ingenious doctrinal fiction of " modified " 
smallpox. Cobbett, in his Advice to Young Men, speak- 
ing with the freedom of a layman, said of this new 
development : " Quackery has always a shuffle left. 
Now that cowpox has been proved to be no guarantee 
against smallpox, it makes it milder when it comes. A 
pretty shuffle, indeed, this 1 " 



CHAPTER XIV. 

COMPULSION. 

I 

THE epidemic of 1817-18 marked the moment of 
greatest hesitation that the profession has ever 
publicly owned since cowpoxing was first assented to. 
Baron says that " professional gentlemen of some name 
took up the opinion of the anti-vaccinists." Perhaps the 
most pathetic note comes from Jenner*s own district. 
His old friend, Gardner, who had been in his confidence 
in the early days, wrote to him from Frampton-on- 
Severn, 21st May, 1817 : — 

"From some unaccountable causes the fame of 
vaccination seems to decline in this part of the country ; 
I find my offers of gratuitous service very frequently 
rejected even by those whose former children have 
undergone the operation." 

The profession seemed inclined for a moment to 
agree with the common people in suspecting that there 
was something radically wrong in Jenner*s teaching. 
In July, 1817, a medical journal in London wrote: 
** However painful, yet it is a duty we owe to the public 
and the profession, to apprise them that the number of 
all ranks suffering under smallpox, who have previously 
undergone vaccination by the most skilful practitioners, 

is at present surprisingly great. The subject is so 

336 



^H PROFESSIONAL INTERESTS. 337 

serious, and so deeply involves the dearest interests of 
humanity, as well as those of the medical character, that 
we shall not fail in directing our utmost attention to 
it"i 

Unhappily the dearest interests of humanity had to 
give way before the dearest interests of the medical 
character. The credit of the profession was at stake. 
A surrender in Jenner's lifetime would have been too 
humiliating, seeing that Parliament had been induced 
to vote him_;^io,ooo in 1802, and ;^20,ooo in 1807, upon 
the warrant of medical evidence. Again, it was unfor- 
tunate that there should be five seats at the Vaccine 
Board, worth a hundred pounds each, for the College of 
Physicians, and three seats for the College of Surgeons; 
the president and four censors of the one College, and 
the president and two senior councillors of the other, 
would have had to e.^ercise some ingenuity to prevent 
these plums from dropping into their mouths. The 
assent of these official personages in succession was 
assured, in the very terms of the arrangement that Sir 
Lucas Pepys had made ; their assent meant the assent 
of their respective corporations;^ and the assent of 

' London Medical Repasitory, ]a\y, 1817 (edited by G. M. 
Burrows and A. Todd Thomson). 

' An instance of faltering conformity has been pointed out to me 
by a literary friend; Dr. John Johnstone, a fellow of the College 
of Physicians and of the Royal Society, edited, in 182S, the Works 
of Samuel Parr, LL.D., with a Memoir. In the latter (i. 649) he 
prints a satirical paper by Mrs. Wynne, Parr's daughter, addressed 
to the Committee of Vaccination at Warwick, upon the discovery 
of ass-pox in a boy al Westminster School, and on the successful 
inoculation of Zebriiie in many more, who had all stood the small- 
pox test eighteen, twenty, and even forty times. Dr. Johnstone 



338 



COMPULSION. 



the two great medical guilds of England meant the 
assent of the whole English profession. 

It was the more unfortunate that these golden chains, 
slight though they were, should ever have been imposed, 
because the medical leaders in London had come to 
form a tolerably accurate personal estimate of Jenner, 
and might have come in course of time to form an 
equally accurate estimate of his cowpox doctrine. It 
was an open secret in the profession that the great 
discoverer was a disappointing person at close quarters- 
He was vain, petulant, crafty, and greedy ; he had more 
of grandiloquence and bounce than of solid attain- 
ments. In London, at least, his presence was a bore, 
and his reputation an incubus, which the profession, 
outside his own small following, would have gladly 
got rid of. Having come to town for the last time 
in the spring of 1814, he wrote to Baron 1' "I am 
quite sick of the life I lead here ; " but he remained for 
several weeks longer, in order to be presented to the 
Allied Sovereigns, in the hope that they would, either 
singly or conjointly, do something for him. The minute 
record of his interviews with these august persons, 
which a literary neighbour drew up for him and pub- 
lished during his lifetime,^ would of itself enable us to 
understand why Jenner was held in small esteem in 



says the paper had been "falsely attributed to him by the ill- 
natured sagacity of some persons." He adheres to vaccination in 
a curiously guarded way, and sincerely hopes that "time will set 
the lasting stamp of benefit upon the experiment, for such it is 

' Life of Jenner, ii. 206. 

' The Berkeley Manuscripts, etc. By Rev. T. D. Fosbrola 
Lond., i8zi,p. 236. 



JENNER AN INCUBUS. 339 

professional circles, even if that were not intelligible 
on other grounds. It was only after several applications 
that the University of Oxford gave him the honorary 
degree of Doctor of Medicine in 1813; while the College 
of Physicians refused to the last, even when he brought 
his Oxford diploma with him as a passport, to admit 
him to its fellowship on the same terms. 

But the whole course of events had helped to place 
this Old Man of the Sea on the back of the profession. 
First, his Royal Society credentials ; then his support by 
men of credit like Cline, Pearson, and Woodville ; then 
the powerful interest of the county of Gloucester in 
Parliament, and of the Berkeley family in particular; 
then the dexterous appeal to the College of Physicians, 
and to its old love of authority ; then the inevitable 
placemen's job of the Vaccine Board whenever Sir Lucas 
Pepys had the chance given him. Those who discover 
in all this the legitimate exercise of professional, or 
expert, or scientific authority, can only do so by closing 
their eyes to the purely mundane and sordid side of 
the history. The medical profession itself, about the 
year 1818, was not far from handsomely owning that it 
had made a mistake. But for the establishment and 
endowment of the Vaccine Board, and the inertia of 
corporation interests thereby brought to bear, it is highly 
probable that such an acknowledgment would have 
been made. 

It was unfortunate, also, that no alternative for the 
management of smallpox epidemics was then in sight, 
except a return to variolous inoculation. From the first 
the anti-vaccinist cause had been far too much the cause 
of those committed to the old inoculation. The more 



340 



COMPULSION. 



5 seen to fail and to do harm, the*! 



that cowpoxing ' 
more did variolation revive. There is abundant evidence 
in those years that variolators were doing a good busi- 
ness, and that the practice had passed more than ever 
into irregular hands. In the disastrous epidemic among 
children at Norwich in 1819, which was due to over- 
crowding of the town by a great influx of families from 
the country while trade was brisk, the failures of vacci- 
nation were so obvious to those directly concerned that 
the common people iiisisted on having their children 
inoculated in the old way to save them from the conta- 
gion. At first only a druggist and some old women 
could be got to do it ; but at length " even a few medi- 
cal men, yielding to the popular clamour, or listening to 
the entreaties of their patients, took up the variolous 
lancet." ^ 

Another general epidemic came in 1824-25 ; and the 
report of the Smallpox Hospital in London emphasized 
the fact, in which there was nothing unusual, that 147 
of the patients had been vaccinated, and that twelve 
of these had died. Sir Robert Peel was questioned 
about this in Parliament, and asked the Vaccine Board 
to inquire into the circumstances. The result of their 
inquiry, communicated to the Government by Sir Henry 
Halford, president of the College of Physicians and of 
the Board, " was so satisfactory as to leave no cause to 
doubt that these individuals had not been properly 
vaccinated." ^ The same apologetic rdk was played 



' Cross, History of the Variolous Epidemic at A'onuich, in it 
Lond., 1S20, pp. 12, 34. 

' Baron, i. 274 ; Med. and. Phys. Joum., May, 1826, p. 436. 



OPPOSITION NEARLY SILENCED. 34I 

by the Vaccine Board from its first establishment until it 
was superseded by official apologists of a more modern 
type. 

The independent medical criticism became feebler, 
and at length ceased. Dr, George Gregory, physician 
to the Smallpox Hospital, was privately known to be a 
sceptic, and he occasionally gave vent to his distrust of 
the Jennerian practice. In the same year of Sir Henry 
Halford's inquiry (1825), Dr. Robert Ferguson, who 
afterwards attained the first rank as a London phy- 
sician, addressed a pamphlet to Sir Henry, proposing 
to use cowpox and smallpox inoculation conjointly, for 
the better security of patients. Ferguson does not 
appear to have taken any public part in the controversy 
in after years ; but the journal which he helped to 
found, the London Medical Gazette, kept its columns 
open to anti-vaccinist contributors. It is significant, 
however, that the opposition had either become anony- 
mous, or was wrapped up in allegory. Thus, in 1839, 
John Roberton, a well-known Manchester practitioner, 
published in the Gazette a satirical piece showing how 
vaccination had failed in the island of Barataria, and 
how the officials had satisfactorily accounted for its 
failure.^ Dr, Henry Holland, writing in the same year, 
could still use the language of critical freedom.' A 



' lj>nd. Med. Gas., Jan., 1839. 

' Medical Notes and Reflections, Lond., 1S39, p, 401, etc. ; " The 
early enthusiasm for the great discovery of Jenner swept doubts 
away ; and they returned only tardily and under the compulsion 
offsets. . , . Any explanation from the ignorant or imperfect 
performance of vaccination was found insufficient to meet the num- 
ber and variety of the proofs." 



342 



COMPDLSION. 



few months after, an anonymous writer in the MediceA 
Gazette, "Scrutator," who is honoured with large type 
and a prominent position, published a series of letters 
of a strongly anti-vaccinist tone. " It is not enough 
for the thinking part of the profession," he wrote, "that 
a few who have the management of this branch should 
be wedded blindly to a particular belief. However 
much our wishes may incline us to favour vaccination, 
we must not be like the advocates of the Old Bailey, 
determined to bring off our client victorious, whether 
deserving or not ; because truth will have its way at 
last; and it may be doubted whether the practitioners 
of the next century will not laugh at the manner 
in which we have been misled by Dr. Baron." ^ That 
was among the last anti-vaccinist protests that were al- 
lowed to appear in an English medical journal down to 
quite recent days. Henceforth the dogmatism hardens, 
and intolerance reaches a height which it had hardly ever 
before touched, even in the most bigoted period of the 
Paris Galenists. The anonymous writer was not far 
wrong when he deferred the general outburst of laughter 
to the next century. 

The very next year (1840), a small circle of medical 
men, holding office in the Medical Society of London, 
petitioned Parliament, through Lord Lansdowne, to 
put down by statute the practice of variolous inoculation 
and to give State-aided facilities for vaccination. The 
disastrous epidemic through which the country had just 
passed in 1838-9 was owing, they alleged, to the neglect 
of vaccination in the first instance, and to the practice 
of variolation in the second. 




DR. SANGRADO. 343 

In the debates that followed, the Bishop of London 

said it was well known that, in agricultural districts of 
the country, there had not been for many years past 
the least difficulty in obtaining vaccination gratuitously ; 
but many of the ignorant poor were strongly prejudiced 
against it, and paid a much greater attention to em- 
pirics than to the advice of the clergy.' Mr. Wakley, 
editor of the Lancet, said, in the Commons, that " no 
one could be ignorant that the working classes of the 
country entertained great prejudices against vaccina- 
tion." In the usual manner of constructive logic, he 
was led to blame variolous inoculation for the whole of 
the 17,000 deaths in one year from smallpox, and gave 
it as his opinion that the disease would die out alto- 
gether if variolation were prevented and vaccination 
adopted.' The legislation of 1840 has been referred to 
in the last chapter but one. 

The inoculation of smallpox came to an end, vac- 
cination was encouraged in various ways, and in many 
parts of the country was as generally practised as it 
has ever been ; but the epidemics continued as before. 
Then, in an evil hour, came the Dr. Sangrado logic, that 
vaccination had failed as a State remedy because it was 
not carried out thoroughly. There was also another 
Sangrado reason in the background. Gil Bias said one 
evening to Dr. Sangrado: "Sir, I take heaven to wit- 
ness that I follow your method with the utmost exact- 
ness ; nevertheless every one of my patients goes to the 
other world." " My child," answered he, " I have reason 



' House of Lords, 16th M3.rch, 1840. 
' House of Commons, 17th June, 1840. 



344 



COMPULSION. 



to make the same observation ; and if I were not as surffl 
as I am of tlie principles on which I proceed, I shouldl 
think my remedies were pernicious," etc. " Let usM 
change our method," said Gil Bias. " I would willingly^ 
make that experiment," replied Dr. Sangrado, " pro-'J 
vided it would have no bad consequences ; but I have | 
published a book in which I have extolled the use of 
frequent bleedings and draughts of warm water; and 
wouldst thou have me decry my own work?" Behind 
all the scientific good faith with which it was recom- 
mended, the first Compulsory Vaccination Act, that of 
1853, was also an Act for the maintenance of medical _ 
authority and for the saving of medical credit. 

The Vaccination Extension Bill, as it was calledJ 
although its object was to introduce the principle andj 
practice of compulsion, was brought into the House c 
Lords early in 1853 by Lord Lyttelton as a privatM 
member. No speech was made upon it until the mo-l 
tion for going into Committee on the 12th April. I..ordfl 
Lyttelton then explained that he was acting in this I 
matter upon the advice of certain able and learnedfl 
persons connected with the Epidemiological Society.':! 
The object of the Bill, he said, was to prevent persons^B 
from spreading the infection of smallpox to others, Thej 
principle had been recognised in the Act of 1840, by^ 
which it had been made penal either to inoculateB 
children with smallpox, or so to expose them that theyi 
would be infectious ; and Lord Lyttelton was advised ] 
that "leaving them unvaccinated did in reality t 
under the last head." ^ 




THE EPIDEMIOLOGICAL SOCIETV. 345 

The able and learned persons who gave Lord Lyt- 
telton that remarkable advice had come together on the 
30th July, iSgo, as the Epidemiological Society. They 
began with a very full programme of subjects that 
called for investigation ; cholera, yellow fever, and other 
epidemics were mentioned, but, strangely enough and 
significantly as the event showed, smallpox was not 
named in the prospectus as a subject for epidemiological 
study, although vaccination was brought into a subse- 
quent paragraph along with quarantine. Most of the 
society's schemes of investigation stuck fast at the out- 
set " for want of funds." ' It started in 1850 with seven 
committees, each having an important theme entrusted 
to it ; but only one of these, the Vaccination Committee, 
reported within the first five years, and some of them^ 
never reported at all. No general meetings were held 
until April, 1854, It would be unfair not to make hon- 
ourable mention of the memoirs communicated to it on 
various interesting epidemics, especially by medical men 
on foreign service who had the vast British empire 
abroad to draw their materials from ; but it may be truly 
said that vaccination was the Epidemiological Society's 
first love, and that it has become a solace of its later 
years. The Vaccination Committee was the first by 
several years to make its report, on the 26th of March, 
1853; and that was the brief from which Lord Lyt- 
telton spoke on the 12th of April. The report was 
ordered by the House of Commons to be printed on the 
3rd of May as a parliamentary paper.' 



' Med, Times and Gaz..^ 14th April, 1855. 
• Parliamentary Papers, vol. ci., 1852-53. 



I 



I 



346 COMPULSION. 

The committee of the Epidemiological Society begin 
their report by remarking that there can be " no doubt 
of the authentic and trustworthy character of the infor- 
mation on which our conclusions are based." They 
then give Conclusion I. : — 

" Every case of smallpox is a centre of cont^ion ; 
and every unvaccinated or imperfectly vaccinated popu- 
lation is a nidus for the disease to settle in and propa- 
gate itself. 

"To the two latter propositions, which do not admit 
of being controverted, we call your special attention, 
for it is on them, we conceive, must be based any en- 
actment for rendering vaccination compulsory. If it 
admit of doubt, how far it is justifiable in this free 
country to compel a person to take care of his own life 
and that of his offspring, it can scarcely be disputed that 
no one has a right to put in jeopardy the lives of his 

I' fellow -subjects " (p. 4). 

A nidus for the disease to settle in and propagate 
itself— 'Cci&l is a phrase which epidemiologists have to 
use constantly,^ and for smallpox among other diseases. 
But the use of nidus in the foregoing constructive sense 
was new to epidemiology. Lord Lyttelton merely 
carried the constructive logic a step farther when he 
said that " leaving children unvaccinated did in reality 
come under the head of exposing them so as to be 
infectious." 
As the main proposition upon which the epidemiolo- 
: 



See Hirsch's Handbook of Geographical and Historical Patko- I 
logy, passim. (English translation by present writer, 3 vols., New I 
Sydenham Society. 1883-86.) 



LOGICAL GROUND OF COMPULSION. 347 

gists rested the case for compulsion did not " admit of 
being controverted," it did not, of course, stand in need 
of proof. The committee, however, did not entirely 
omit to furnish evidence; more particularly, they gave 
some marvellous instances, which had been brought to 
their notice, of towers in Siloam falling upon the un- 
vaccinated exclusively. Their special attention to these 
portentous events, together with their disregard of the 
totality of factors determining the incidence of small- 
pox in time and place, serves to mark the early stage 
that the science of epidemiology had then reached. 
All the sciences have begun with the marvellous ; thus, 
pathology, which stands nearest to epidemiology in 
subject-matter, was almost entirely occupied for many 
years with monstrosities and curiosities. 

The inability of these early epidemiologists to deal 
with the evidence in any other way than begging the 
question was shown in that part of their report which 
brought to light the neglect of vaccination in certain 
localities. There had been a great deal of vaccination 
in some places since the Act of 1840, and very iittle of 
it in others ; there had been also a good deal of small- 
pox in some places, and little or nothing of it in others. 
Leicester, Loughborough, Derby, Ashford, Taunton, and 
the like were shown to have been negligent of optional 
vaccination ; now, was it the case that they had paid 
the penalty by becoming each "a nidus for smallpox to 
settle in and propagate itself" ? The epidemiologists 
did not allege that they had ; and we may safely affirm 
that so strong a point would not have been passed over 
except for the reason that it had no existence. They 
were pleased to say that their nidus-doctrine did not 



348 



COMPULSION. 



I 



admit of being controverted. Nidus was a good word ; 
in English it means a nest, but in Latin it might carry 
as much constructive meaning as the exigences of the 
case required. 

The only person who showed a knowledge of what 
a nidus of smallpox really amounted to was Lord 
Shaftesbury, who remarked, in the debate, that "small- 
pox was chiefly confined to the lowest class of the 
population, and he believed that, with improved lodging- 
houses, the disease might be all but exterminated." 
But Lord Shaftesbury had presided at the inauguration 
of the Epidemiological Society three years before, and 
he was bound to defer to his expert friends when they 
solemnly assured him that it was non-vaccination which 
formed the nidus for smallpox to settle in and propa- 
gate itself I repeat that the programme of the Epide- 
miological Society did not even mention smallpox 
among the great epidemic maladies which required to 
be studied according to the ordinary methods of histori- 
cal and geographical research, or dealt with according 
to the ordinary principles of sanitation. 

The first Compulsory Vaccination Bill ran through 
both Houses without opposition. How such an actj 
without a reasoned motive in its preamble, and without 
scientific definitions in its clauses, could have got upon 
the statute-book in the year 1853, must ever remain one 
of the marvels of our legislative history. It was the 
secure hour of eminent persons, when even the minor 
offices of the coalition ministry were filled by past- 
masters in the art of legislating. The following con- 
temporary estimate of the session will be read now with 
interest ; — 



I 




REVIVAL OF DISSENT. 

"As the spring advanced, and measure after measure 
passed successfully, opposition grew weaker and weaker, 
till at last discussion was almost reduced to the candid 
statement of objections and suggestion of difficulties. 
Here is the bright spot of the year 1853; the patriot 
may dwell on the labours of our Parliament with plea- 
sure, and the future historian may perhaps find occa- 
sion to record that about this period the Parliamentary 
system of Great Britain had reached its highest perfec- 
tion." ^ 

The party of vigilance in the House of Commons 
awoke from their enchantment next year (1854), when 
vaccination came up again in connexion with a technical 
Amendment Bill."^ In 1856 another bill, promoted by 
the Epidemiological Society, of a much more dictatorial 
kind, was about to be passed as an unopposed measure ; 
but the minister in charge of it was obliged to give a 
pledge to Mr. Duncombe that it would not be taken 
after midnight, and it was found to be of such a kind 
that it was discharged by the general wish of the House 
when it came into Committee on the loth July. 

Meanwhile there began among the public that modern 
anti-vaccination movement which has slowly assumed 
the proportions of a revolt against the compulsory law. 
In 1S54 Mr. John Gibbs published anonymously Our 
Medical Liberties, and followed it up next year with a 
letter on Compulsory Vaccination addressed to the 



' " TMe Times' " Annual Summaries, i85i-i8?5, p. ai. 

' The minority consisted of Mr. Barrow, Mr. Joseph Brotherton, 
Mr. Thomas Duncombe, Mr, Frewen, Dr. Michell, and Sir George 
Strickland. 



3SO 



COMPULSION. 



President of the Board of Health, which the House i 
Commons, on the motion of Mr. Joseph Brotherton, 
ordered to be printed on the 31st of March, 1856. This 
led to the medical blue-book of 1857, on Tlie History 
and Practice of Vaccination, in which the position of 
the epidemiologists in 1853 is somewhat varied: "It 
was the liberty of omissionat infanticide which the 
law took courage to check." Those among the public 
who had made a study of the history and practice of 
vaccination were not satisfied with these medical deliver- 
ances. If they did not always ask their question " with 
Olympian politeness," yet they kept asking the question, 
But is it so ? Is the unvaccinated residue really a 
nidus for smallpox to settle in and propagate itself? 
Is not all this terrific logic about checking the liberty 
of omissiona! infanticide merely an ingenious super- 
structure upon a radically unsound basis? 

No answer to the question, by those who had the offi- 
cial means of answering it, was ever given or attempted, 
until the results of the great epidemic of 1870-1872, 
particularly of the German portion of it, proved once 
for all that the unvaccinated residue were not what the 
Epidemiological Society's Committee had said they 
were ; that is to say, they were fiot a nidus for smallpox 
to settle in and propagate itself, they were not a col- 
lection of combustible materials, they did not put the 
lives of their neighbours in jeopardy. Absence of vac- 
cination did not amount to omissional infanticide, 
far not so that the German Government in 1S74 ex- 
tended the age for vaccination to two years. Among the 
records of that epidemic in Germany, one of the greatest 
in the whole history of European smallpox, (124,948 



I 



TESTED BY RESULTS. 3SI 

deaths in Prussia in two years, 1871-72) are the lists 
kept by the poHce in chronological order of the persons 
attacked in each locality. These lists are now known 
to be much less perfect as regards the facts of vaccina- 
tion or non-vaccination than was supposed, but even from 
the partial revelations certain conclusions are at once 
obvious. It is found that the first unvaccinated person 
is generally a good long way down the list.' It was 
not among the unvaccinated that the epidemic in each 
of its several centres took origin and gathered head ; the 
unvaccinated had no more than their share of the epi- 
demic, and not always that. 

For Bavaria, whose vaccination arrangements had 
been held up as a pattern to other States, the facts for 
the year 1S71 were published fourteen years ago by 
a medical official of the bureau of statistics at Munich.' 
The cases of smallpox in 1871 were 30,742, of which 
the vaccinated were 29,429, or 957 per cent., and the 
unvaccinated 1,313, or 4-3 per cent. There were 3,994 
deaths among the vaccinated cases, a rate of lyB per 
cent. ; among the unvaccinated, there were 790 deaths, 
a rate of 601 per cent. But 743 of the latter were in 
infants under one year, leaving 47 deaths of the un- 
vaccinated of all other ages. The excessive mortality 
of infants is, of course, not peculiar to smallpox. 

As Moseley said in 1806, it is always possible for the 
apologists to get up " a squabble about mis-statements." 



' At Bonn the 42nd, Cologne the 174th, and at Liegriitj the zzjth. 
In a recent official work (Berlin, 1 888), it is stated that the lists from 
Liegnit;! are unfortunately without data a: 

' Majer, Vierteljahrickri/t fiir gerkht. Med.,: 



I 3S2 



COMPULSION. 



I 



But it will be difficult to confuse the issues from such 
broad facts as these. There is, indeed, no longer any 
attempt to do so, unless it be here and there by an 
official in the exercise of what he conceives to be his 
duty. 

The vaccination law in England was made more 
rigorous in 1861, 1867, and 1871, on the Sangrado 
principle of giving State blood-letting and hot water 
a fair trial. In 1880 the ministry of the day brought in 
a Bill to relax the penal clauses ; they thought that one 
fine, distraint or imprisonment would be enough in the 
case of each child, instead of prosecutions at intervals 
until the child was fourteen years old. The ministry had 
to abandon their Bill, owing to the opposition of the 
medical profession and the Royal Society. Among the 
petitions presented against the Bill was one from certain 
members of the British Medical Association, which con- 
tained the following clause : 

"3. That the outcry against compulsory vaccination 
is mainly due to certain interested persons, who, by 
the dissemination of inflammatory literature, and by 
the propagation of falsehoods and distorted statements, 
stir up opposition to vaccination on the part of ignorant 
and thoughtless people," ^ 

These accusations are but the angry words of discon ■ 
certed professional opinion, when it finds out that there 
is a power in the State setting its authority at defiance. 
The anti-vaccinists are those who have found some 
motive for scrutinizing the evidence, generally the very 
human motive of vaccinal injuries or fatalities in their 



ATTITUDE OF THE PUBLIC. 3S3 

own families or in those of their neighbours. Whatever 
their motive, they have scrutinized the evidence to some 
purpose ; they have mastered nearly the whole case ; 
they have knokrlved the bottom out of a grotesque super- 
stition.' The public at large cannot believe that a great 
profession should have been so perseveringly in the 
wrong. The present attitude of the public may be said 
to illustrate the truth of a maxim of Carlyle's : "That 
no error is fully confuted till we have seen not only tliat 
it is an error, but how it became one." The task which I 
set before me when I began this book was to explain to 
myself how the medical profession in various countries 
could have come to fall under the enchantment of an 
illusion. I believe that they were misled most of all by 
the name of "smallpo.K of the cow," under which the 
new protective was first brought to their notice. For 
that grand initial error, blameworthy in its inception, 
and still more so in the furtive manner of its publication, 
the sole responsibility rests with Jenner, 

The profession as a whole has been committed be- 
fore now to erroneous doctrines and injurious practices, 
which have been upheld by its solid authority for genera- 
tions, Lesage's satire upon blood-letting, in Gil Bias. 
which appeared in 1715, ought of itself to have made 
that practice ludicrous in the eyes of the world ; but 
blood-letting survived a hundred years after that in all 
countries ; and in the country of Sangrado it survived a 
hundred and fifty years. The apology for it, or explana- 



' See The Slary of a Great Delusion, by William White, Lond., 
1885, and the serial volumes of the Vaccination Inquirer, from 
1879. 

- A A 



[354 



COMPULSION. 



» 
» 



tion of its abandonment, which was still being taught 
in lectures twenty years ago, was that diseases had 
changed their type from sthenic to asthenic, and that in 
our asthenic age blood-letting was no longer necessary. 
It is difficnlt to conceive what will be the excuse made 
for a century of cowpoxing; bat it cannot be doubted 
that the practice will appear in as absurd a light to the 
common sense of the twentieth century as blood-letting 
now does to us. Vaccination differs, however, from all 
previous errors of the faculty, in being maintained as the 
law of the land on the warrant of medical authority. 
That is the reason why the blow to professional credit 
can hardly help being severe, and why the efforts to ward 
it off have been, and will continue to be so ingenious. 

The longer the compulsory law is maintained, the 
more marked will the contrast become between public 
intelligence and professional dogma. As for the public, 
they may escape, as soon as they please, from being 
dragooned by an official authority which is neither very 
learned nor very liberal. When the deliberate sense of 
the kingdom is known, as Burke says, "it tnust be 
prevalent. It would be dreadful indeed, if there were 
any power in the nation capable of resisting its unani- 
mous desire, or even the desire of any very great and 
decided majority of the people. The people may be 
deceived in their choice of an object ; but I can scarcely 
conceive any choice they can make to be so very 
mischievous as the existence of any human force capable 
of resisting it." 



^ i» X 



\l*lc 



THE COWPOX LEGEND IN GERMANY. 

{Note top. 21.) 

There is an authentic record that the protective virtue of cowpox 
had been talked of in the country near Gottingen previous to 
1769. In a paper attributed to Jobst Bose, on "Pestilence of 
Cattle; and on Passages in Livy," published in the Allgemeine 
Unterhaltungen for 24th May, 1769, p. 305, cowpox is mentioned 
as an example of a disease which men suffer from as well as 
animals. "It is true," the writer continues, "that men do not die 
of it any more than cattle. But sick enough can the people be 
from it, all the same. In passing, I must mention that the people 
in this part of the country [Gottingen] who have had cowpox {fCuh- 
pocken) flatter themselves entirely that they are secure from all 
infection of our ordinary smallpox {Blattem\ as I myself have 
several times heard from quite reputable persons." This was 
reprinted in 1802 by Steinbeck in his monthly journal, the Z?^«/j^^^ 
Patriot^ January, pp. 43-46 ; and may be conveniently referred to 
in K. F. H. Marx's Gottingen in medicinischer^ physischer, etc,^ 
Hinsicht, Gott., 1824, p. 326. 

A corresponding legend had been current in Holstein previous 
to 1 79 1. In that year, Plett, a poor schoolmaster near Kiel, is 
said to have inoculated children with cowpox. His narrative was 
not committed to writing until 181 5, when it was taken down from 
his own lips and printed in the Schleswig- Holstein Provincial 
Berichten, 18 15, p. jy (copied into the Literatur-zeitung oi Leipzig, 
loth June, 1815, p. 11 13, and here quoted from Choulant, ** Edward 
Jenner," in Zeitgenossen, 1829, Pt. vii., p. 12). Cowpox is through- 
out written Kuhblattern (smallpox of the cow), and not Kuhpocken^ 
smallpox being called Kinderblattetn^ Menschenblattem^ and natiir- 
liche Blattern, Plett, we are told, "betook himself to the cowhouse, 
examined the pocks {Blattern) on the cows' teats, and when he 
found a good one, which looked ripe, he cut it open with his pen- 
knife, collected the matter on a chip of wood as it ran out, and 
returned with it to his schoolroom." The mythical element in 
the narrative, as written down, is obvious ; no one has ever got 
vaccine from the cow by ripping up a pock with a penknife. It 
does not follow, however, that Plett had not inoculated some kind 
of fluid from a cow's teat upon the human skin. It is not alleged 
that his practice found favour. 

356 



INDEX. 



Abemethy, Mr., cases of cowpox, 88, x86. 
Adam$, Joseph, reference to coWpox, 35 ; 

pearly smallpox, 334. 
Addington, Lord Sidmouth, on Jenner's 

claim, 201. 
Addington, surgeon, cowpox ulcers, 151, X77. 
Albers, Dr., tests at Bremen, 216. 
Alsop, surgeon, and Ingen-housz, 86. 
Amiens, J[ury of Health, 265. 
Anti-vaccinists, scrutiny by, 353. 
Apologies for failure, of variolation, 142 ; of 

vaccination, 155. 
Assent, speedy, in England, 189-192 : New- 
man on, 298. 
Austria, proclamation, 236. 
Authority, scientific, 204. 
Baillie, Dr. M., evidence of, 199. 
Baker, Sir George, adopts Sutton's method, 

137 ; on experiments, 142. 
Baker, John, horse-greased, 66-68. 
Ballhom tries cowpox at Hanover, 206, 209. 
Banks, Sir Joseph, employs Jenner, 2, 3 ; gets 
him made F.R.S., 11 ; dubious about cow- 
pox, 37 ; the Royal Society under, 47 ; 
inspects Woodville's cowpox, 98 ; investi- 
gates a failure, 181. 
Baron, biographer, 3, 8, 9,72. 
Barrington, Daines, 9. 
Bavaria, takes vaccine on faith, 230 ; official 

statistics of failure, 351. 
Bay ley. Miss, 216. 

Beckett, original use of "pox," 29, 32. 
Beddoes, Dr., early reference to cowpox, 36 ; 
Gloucester cowpox, 56 ; writes to Hufeland, 
89 ; proposes subscription, 375. 
Berkeley, Admiral, 193, 202. 
Berlin, first vaccine at, 217. 
Birch, John, eives evidence, 195, 20J, 315. 
Blane, Sir Gilbert, 196. 
Blumenbach, anatomist, 188, 205, 207. 
Boringdon, Lord, his bills, 332-3. 
Boddington, surgeon, 132. 
B5se, Jobst, cowpox at G5ttingen, 356. 
Boufflers, Duchesse de, case of, 138, 241. 
Bremen, 215. 
BreslaUj 222, 223. 
Bromfeild, W., on variolation, 240 ; his 

failures, 141. 
Brown, of Musselburgh, 331. 
Brown, antivaccinist, shoots himself, 314. 
Burdett, Sir Francis, a failing experiment, 327. 
Burges, James, on variolation, 134. 
Canning, Mr., no compulsion, 328. 
Careno, of Vienna, 231, 237. 
Cassel, Hesse, 229. 
Ceely, Robert, 42, ^3, 61, 270. 
Cigar- pox, in Belgian soldiers, 152. 
Clapham, cowpox ulcers, 79, 178. 
Clayton, familiar with cowpox and grease, 56, 

60. 
Cline, Henry, tries cowpox, 71 ; letter edited, 

91. 
Cobbett, William, 315, 335. 



Coleridge, S. T., on vaccination, 331. 
College of Physicians, vaccine committee, 323 ; 
refuses to admit Jenner, 339 ; seats at vaccine 
board, 337.^ 

Colon, Dr., pioneer in Paris, 256 ; on mystery 
of vaccine, 202. 

Comit€ Central, 242. 

Committee, parliamentary, of 1802, 193. 

Conscious View, pamphlet, 84, 85. 

Convivio-Medical club, cowpox discussions, 54. 

Cooke, of Gloucester, adverse cases, 57, 59 ; 
recants, 315. 

Comwallis, Marquis, at Amiens, 265. 

Creaser, surgeon, 190. 

Cowpox, Jenner's first reference to, 19 ; an- 
tiquity of, 20 ; described by Clayton, 56 ; 
spontaneous, 61 ; " spurious," 62, 87, 163, 
169 ; a filthy disease, 84 ; analogy to great 
pox, 1 18-122, how far like horse-grease, 123; 
discovered by Sacco, 269 ; first figured by 
Sacco, 270 ; Ceely's picture of, 270. 

Cowpox Chronicle^ 329. 

"Cuckoo, Natural History of," 8, 11,14-17, 
207. 

Darmstadt. 229. 

Darwin, Charles, on cuckoo's instinct, 13, 17. 

Darwin, Erasmus, vaccination and christening, 
188. 

Davison, Francis, " small-pocks " in his RaP- 
sodie, 30. 

De Carro, spurious vaccine, 214, 234 ; pioneer 
in Vienna, 231, 233, equinator, 278, 279 ; 
vaccine mystery, 293. 

Denman, Dr., cowpox a novelty, 78 ; weighty 
support, 175, 186, 1^0 ; evidence, 196. 

Denmark adopts vaccine on trust, 216. 

Derby, Earl of, writes to Denman, 175. 

Dimsdale, Dr., his variolations, 139. 

Dbtemper, vaccination for, 237 ; Jenner's 
paper on, 237. 

Donne, Rev. Dr., his use of word "pox," 30. 

Dorset, cowpox legend in, 21, 194. 

Drake, of Stroud, 92, 95, 127. 

Dufresne, of Toux, fails with vaccine, 261. 

Dunning, surgeon, logical position, 176 ; de- 
finition of vaccine, 292 ; letters to, 319. 

Edinburgh, assent gained, 187. 

Edinburgh Review^ on Jenner's "concise 
history," 162 ; on Moseley, 312. 

EUenborough, Lord, his bill, 303. 

EUenborough, Lord Chief Justice, 322. 

Enthusiasm, at Berlin, 219, 222 ; Breslau, 223 ; 
Paris, 247. 

Epidemiological Society, promotes compul- 
sion, 344-8. 

Erlangen, cowpox found, 231. 

Eschars, meaning of, after cowpox, 45, 1x9, 
120. 

Estlin, Mr., vaccinal eruptions, 153. 

Evans, of Ketley, variolous tests, 130; vac- 
cinal eruptions, 153. 

Exanthem, proper to cowpox, 153, Sacco on, 

273' 



357 



owoThor 



rflwtiar, Mr,, cKpen la cowpox, ts, 94, sa'. 

Forbo, af DmilKrweU. wiobui l«l, 13]- 
Fubroke, Kev. T. D., upUliu '' var^lai 



Fox, C. J., IB 



Wm. in., impartiality, : 



diuIEd, HT. 

Friue. of Btuliu, tries n 
PMHAirOiicrvBluHi, pu 
Clklti, Tariolator by dew in 






: by Ssco 
» oC'Hoit. I 



Hcberd'^.canl^^riDUling, iji. 
Becker, the elder, lapid protreu 

Reim, had heard of cawpox, 22 ; u 

u BKlin, iij. 
Herpes, doclriM of, 154. 
Uera, Marcus, against vaccine, 918 
Bihemaiion. JenntrsreKareheso 
Hicks, Dr., " why hesitate )" on. 
Hicks, Henry, children vacdnaK 

HoJinslied, mentions soiaUpox, 36. 
Holland, Richard, ccmplue variola 
Holstein, cowpoT legend, >., JsS. 
Holt, Re>. R., Gods cowpox, i». li 
Home, Sir Evetard, pupil with 
reports agoiiiBt Injitiryt 37, 47 
grudge against. 50 ; gives eiiden 
Hooper, Dr., falsi stnaSpoi after u 

HugS' M'nr=dve'i^''c^oL''al ili, 
""" ■ r, John, Jennet boards witl 



InKen-houK, Dr., career. 85 ; tollects evidence 

ik Wilu, M -. retires Irom conlroveny, 8S : 

on '^ spurious ' smollpov. ifa. 
Jnociilaiion, of smallpoK, old methoiL lu ; 

new method, .,£ i ■'^spuriom," im- 
/■(l-.Vr, Jenner's. title-page of. «, 78 ! 

publisbed, 49 ^ prebce, ja : reception of, ;S. 

isolalioD, plan for smalipoi;, i, 
J acob^^ilr.. solicitor, knew ■ 

ssf"""""" 



upil in London. 3 ; ana- 

tpers, 8 ; paper on the 
J F.R.S., 19; iicst sketch 
ppoicd by his CDlleoEUCs, 



vaccinates ian.es P 
to Koysl Society. 3 



pox, 52, 69 ; comet to London ia publish the ' 

answmlnKen-hDuss,a7, 165; hasnolymph,' 
90 : liiils to taise new stock, qi ; tind^ cow- 
pox at Stonehouse, 9a 1 pnidnces ulcers with 

suppresses Drake's inforrnation, 05 ; again 

ville, 09. loB :' reports on cRecu of Wosd- 
viUeslyDph, iit; mystlBes the public about 

employs Marshall to start it, 114; repl.cs 






» statue by Monteverde, aAo ; 
ate his child, 189 ; but ■ana- 



suppli« Pisleur with 



INDEX. 

ihf fir^tlenncrians, .84 : His ( 
Mii]^vc, Earl of. on ihc poor 1 

Colon on, 1^3: De'Carroon, as 



i, 33=; Gros 
Coleridge, 3 

0, '■ Spuriou: 



jMty, Farmn-, cowpoiM his family, aj, »s 

TonB'ioljiiGalc,3>6. 
XiKE, WlLLiaio, case of, .;, a«. 
Knighl, Fmncis, ra.iy suppDrler of Jenntt 
,0, 186, 1^. 

LoDgton, Dr-, bt^us inoculation, 141. 
LansdownE, Marquis of, advisei ksisladDn 



te; 



™&ft,....,.~ 



LandsK MtdieM Cauite, ap;i 
Z-mdim' Mtkieat Rcfstitory, . 
Lyiteltan, Lord, hia Aql, ^ 



. 3M-*- 



Maresdiau, Dr.. reply loVerdicr, 1. 

Marshall, of Easlington, emplayed 
lymph, irj, 114 ; Inu fifiy per o 
work and reel in Palsmu^, a3S. 

Ma»a. Nicholaa, on pustules, ai- 

Mtdicra and Ptyikat Jtnmal, o 
asKnt, iDo ; logendaty J«dncr, iC 



u House of Lords, 31 



Milken, cowpok cS, 39 
Monleverde, sculptor, 
Montpelller, legend <^ 
Moore, James, histc 
If nnei and Harvey, 



359 
he rich. 



as;.? 

Ottley, n 


Profe 


C<7« 

«r. 


iSie'c^ 
, .?! , Jenne 


nalysiaofj 
Illy, »7. 

■s degree, 




J., 00 


lives 


fmensndan 


unala 
93-" 


S76. 


^r? 


cS,iSddr 

3,.sS;.™? 


i^£, Ve- 
nial (allures, 
n in iBoa, 


oiu 
^ia 



™.!fi5™53 



Pepya, Sir Lues 



Phipps, Jaa 
Plague, vaci 
Plett. of He 



■, of syphilis, 3'-33 : used for I 
lie, Lord, apposes legislation, 
jurt;, no theory of vaccine, ^% 



% St. 6™ G?,1l 



•5d^ 



36o 



INDEX. 



Ruston, Dr., ino'culator, 150. 

Sacco, Luigi, his career, 367 ; finds cowpox at 
Varese, 268 ; his plate of cowpox on the 
cow, 270 ; his ]ymph, 271 ; cowpox not 
spontaneous, 27a ; his worm-pathology, 373; 
experiments on animals, 274 : vaccinates for 
sheep-pox, 275 ; uses sheei>-pox as vaccine. 
277 ; adopts horse-grease virus, 277 ; comes 
to Milan, 279 ; greatest vaccinator in the 
world, 280, 285 ; on Jenner, 281 ; checks 
epidemics, 282 ; his formal test at Milan, 
283 ; at Florence, 284 ; oration at Vienna, 
286 : on vaccine mystery, 293. 

Sal made on bogus inoculation, 41 ; member 
of Comity Central, 243, 251 ; his method, 
252-254, 259. 

Scarlet fever, vaccination in, 237. 

Schulz, of Berlin, writes to the king, 219 ; and 
the Czar, 231. 

Selke, Dr., case' of Ricord's, 119. 

Shaftesbury, Earl of, 348. 

Sheep-pox, vaccine does not prevent, 337 ; 
Budd on, 275 ; used on children, 277. 

Shorter, Mr., reassured, 131. 

Simmons, prompt assent at Manchester, 191. 

Sims, Dr. John, objections to cowpox, 82 ; 
silenced, 185. 

Smallpox, first mention in English, 26 ; in 
France, 27 ; in i7th century, 27 ; not the 
pox proper, 29 ; Jenner invents ' * spurious " 
variety, 87, 144, 168 ; ** modified," 180, 286, 

SOmmerring, test at Frankfurt, 226. [335 

Somerville, Lord, 37, 98, 104. 

Spurious cowpox, the plea of, 156 : sources of, 
159, 163, 165 ; a mere cry, 161, 168 ; repudi- 
ated by College of Physicians, 168 ; Ingen- 
housz on, 168 ; H. Jenner on, 170 ; Fosbroke 
on, 171 ; G. C. Jenner on, 172 ; plates of 
promised, 173 ; Stevenson on, 174, Dunn- 
ing on, 176 ; double use of, 177-5 '. .*^* 
leaders on, 197-9 ' GOttingen dennition, 
213; Vienna, 214, 234; Paris, 243, 246; 
Versailles, 255 ; Brussels, 260 ; Toux, 262 ; 
Lyons, 264. 

Stark, Dr., name of cowpox, 20. 

Stanhope, Earl, opposes legislation, 333. 

Stevenson, Dr. John, on "spurious," 175. 

Stiles, farmer, case of, 86. 

Stokes, Dr., spurious vaccine, 173; the public 
willing, 193. 

Stonehouse, severe cowpox at, 92. 

Stromeyer, uses cowpox at Hanover, 206, 209. 

Struve, evidence from GSrlitz, 224 ; scarlet 
fever prevented, 236. 

Stroud, early trial at, 95, variolous tests, 127. 

Summers, William, first vaccinifer, 69. 

Sutton, Daniel, formal inoculation, 40, 126, 
X37-139, 142 ; produces smallpox in the 
vaccinated, 149. 

Syphilis, the original pox, 31 ; vesicle of, 118- 
122 ; vaccinal, 287. 

Tanner, assists Woodville, 104 ; gets cowpox 
for Jenner, 113. 

Test, the variolous, as prescribed by Jenner, 
40 ; on James Phipps. 46, 126 ; omitted, 74 ; 
at Stroud. 94, 96 ; by Woodville, 129 ; Ward, 
130 ; Forbes, 133 ; in England, 146 ; at Han- 



over, 309 ; Bremen. 316 ; Berlin, 217, 321 ; 

Breslau, 333 ; Gdriitz, 334 ; Frankfurt, 226 ; 

Meissen, 330 ; Vienna, 234, 335 : Paris, 243; 

351, 356, 358, 350 ; Versailles, 255 ; Lyons; 

264 ; Amiens, 260 ; Varese, 279 ; Milan, 283 , 

Florence, 284. 
Thomson, Dr. J., modified smallpox, 334. 
Thomtoni Mr., ulcerous cowpox, 93 ; test fails, 

127. 
Tiemey, Sir Matthew, assent at Edinburgh, 

187. 
Toux, failures at, 361.^ 
Trotter, Dr., careful inoculation, 148 ; chara* 

pion of vaccine, I87. 
"Truth, believe me, sir," 1, 18. 
Tyndall, Professor, on attenuation of virus, 308. 
ulceration of cowpox, 97, 150, 178. 
Vaccine, new name for cowpox, 78, 340 ; same 

as equine, 378 ; extended by Pasteur, 307 ; 

Tyndall on, 308 ; figure of speech, 309. 
Vaccine Board, 339, 337, 340. 
" Vacco-variolist, defends Jenner, 81, 82. 
Varicella, applied to smallpox, 180. 
Variola, mediaeval name of smallpox, 27, 32. 
Variola ovina, yiboi:g on, 337 ; Budd on, 275 ; 

used as vaccine, 377. ^ 
''Variolae Vaccinae, misleading name, 44, 73, 

76, 78-83, 97j xx8, 134 ; in Germany, 20S, 

334 ; in Austria, 333 ; in France, 239-241 ; in 

Italy, 369-37X, 377 ; in Parliament, 303, 305. 
Varioloid, modifiea smallpox, i8of 286, 335. 
Variolous test, see Test. 
Vaume, Dr. Joseph, (^poses vaccine, 245, 251. 
Verdier, Dr. Jean, cnuc of Jenner, 240, 247, 

Virole^ introduced, 38. 5U- / 

ViroUt ^iite^ introduced, 37. 

ViroUt Petite des vacAes, 78, 240. 

Versailles, vaccine tried, 354. 

Vesicle of syphilis, 34, isx ; of horse-grease, 
63, 133, 378. 

Viborg, vaccination for sheep-pox, 337. 

Vienna, vaccine tried, 333 ; variolous tests, 234, 
33^: equine lymph, 379. 

Volsm, experience at Versailles, 354. 

Ward, M., variolous tests at Manchester, 130. 

Wardenbur:g, Professor, tries vaccine, 207 ; at 
Oebisfelde, 313 ; doctrine of " spurious," 213. 

Watts. Dr. Giles, on mild variolation, 140. 

Weigel, experience at Meissen, 229. 

White, Gilbert, on the cuckoo, t2, 13. 

White, William, historian of vaccination, iv. 

Wilberforce, Mr., supports Jenner, 201 ; con- 
sensus of Europe, 303 ; addressed by Cobbett, 

315- 

Wolfram, Dr., his child, 363. 

Wollaston writes to Jenner, x88. 

Woodville, Dr., cov^pox in London, 98-100; 
his career, loi ; objects to horse-grease, 102 ; 
supplies the world with lymph, 103 ; mild 
type of cowpox, 107 ; his Reports^ 108 ; his 
services, H4-1X7 ; variolous tests, 127-129 ; 
method of variolatinfj, 143 ; avoids contro- 
versy, 167 ; gives evidence, 194, 196 ; re- 
viewed in Austria, 233; takes vaccine to 
Paris, 393 ; his death, 333. 

Worthington, Rev. Dr., 36. 



Butler & Tiuiner, The Selwood Printing Works. Frome. and London. 



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